The appendix: An unexpected band obstruction

Abstract

Introduction: Small bowel obstruction (SBO) is common surgical pathology, most commonly secondary to adhesions. This case presents a novel cause of small bowel obstruction. Case Report: We present a case of an elderly female who presented to hospital with symptoms, signs, and radiological findings consistent with SBO. After failing non-operative management, and deteriorating clinically, decision was made for operative intervention. A laparotomy revealed a normal-appearing appendix adhering to the pelvic side wall, and consequently forming a band adhesion-like internal hernia and was the cause of the bowel obstruction. Following dissection from the pelvic wall, and appendectomy, the patient recovered and was discharged home. Histopathology demonstrated a normal appendix. Diseased appendices have rarely been described to cause bowel obstructions; however, this is the first case report describing a normal appendix causing a band-like bowel obstruction. Surgical management was necessary to establish a definitive diagnosis, and for resolution of the condition. Conclusion: This case highlights a novel cause of SBO and reiterates the heterogeneity of SBO causes. Abdominal exploration remains the gold standard diagnostic modality for intra-abdominal pathology.