Small bowel gangrene due to inflamed appendicular band: a case report

Abstract

Appendicular band syndrome also called appendicular knot or tie is an extremely rare complication of acute appendicitis the world over. Adynamic small bowel obstruction or ileus is not uncommon in all forms of peritoneal inflammation but anatomical small intestinal obstruction or gangrene due to appendicular tourniquet is a rare condition and only a few cases have been reported. We report the case of a 44-year-old man with clinical features suggestive of ruptured appendix, who at laparotomy was found to have gangrenous distal ileum due to inflamed appendicular band. Post-appendectomy, he had right hemi-colectomy done owing to non-viability of the gangrenous distal ileum. Post-operative and follow-up periods were non-adversely eventful. Despite its rarity, the possibility of such diagnosis in the evaluation of a patient with acute abdomen should not be overlooked especially in the absence of an identifiable aetiology. In addition, the diagnosis of mucinous
cystadenoma from the excised appendix re-emphasizes the importance of submitting surgical specimen for histopathology.

Keywords: Small bowel gangrene, Inflamed appendicular band