Perforated appendicitis presenting with ileo-caecal ulceration and mechanical intestinal obstruction. 2008

H Kareem, and S Sebastian, and T Jose, and V Thomas
Department of Gastroenterology, Calicut Medical College & PVS Hospital Kozhikode, Kerala, India.

A 30-year-old lady presented with a 6-month history of recurrent partial intestinal obstruction associated with intermittent fever, anorexia and weight loss. Barium meal follow-through and colonoscopic evaluation suggested ulceration of the ileum and caecum with small bowel obstruction. Histology of the lesions showed marked acute and chronic inflammation consistent with ulceration and granulation tissue. Abdominal CT revealed circumferential thickening of the ascending colon, caecum and terminal ileum with extraluminal air pockets. Surgical exploration revealed a large conglomerate mass involving the terminal ileum, caecum and ascending colon. Histopathology of the resected specimen revealed perforated appendix with nonspecific ulceration of the surrounding bowel. She recovered completely after surgery and did not suffer from gastrointestinal symptoms in the 14 months of follow-up.

UI MeSH Term Description Entries
D007079 Ileitis Inflammation of any segment of the ILEUM and the ILEOCECAL VALVE.
D007415 Intestinal Obstruction Any impairment, arrest, or reversal of the normal flow of INTESTINAL CONTENTS toward the ANAL CANAL. Intestinal Obstructions,Obstruction, Intestinal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001064 Appendicitis Acute inflammation of the APPENDIX. Acute appendicitis is classified as simple, gangrenous, or perforated. Perforated Appendicitis,Ruptured Appendicitis,Appendicitis, Perforated,Appendicitis, Ruptured
D053706 Typhlitis Necrotizing inflammation of the CECUM ("typhlon" in Greek), sometimes spreading to the APPENDIX and/or the ILEUM. Symptoms include ABDOMINAL PAIN and DIARRHEA. Its pathogenesis is multifactorial. Typhlitis is often associated with NEUTROPENIA and chemotherapy in immunocompromised individuals (IMMUNOCOMPROMISED HOST). Cecitis,Neutropenic Typhlitis,Typhlitis, Neutropenic

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