e-Algerian Journal of Health & Research
Volume 3, Numéro 1, Pages 91-101
2026-10-20
Mechanical Small Bowel Obstruction Secondary To Acute Appendicitis: A Case Report And Review Of The Literature
Authors : Taha Mohamed Hassan . Abdalla Eltayeb . Mahmoud Esra . Alkhalifamohamed Hussam . Omar Amany . Ismail Hossam Ibrahim Abdulhameed .
Abstract
Background: Acute appendicitis and small bowel obstruction are among the most common causes of acute abdomen requiring surgical intervention. However, mechanical small bowel obstruction secondary to acute appendicitis is a rare clinical entity that may obscure the classical presentation of appendicitis and lead to diagnostic delay. Case presentation: We report the case of an 18-year-old male who presented with a four-day history of progressive abdominal pain, dysuria, nausea, anorexia, and intermittent fever, followed by vomiting, abdominal distension, and features suggestive of intestinal obstruction. Laboratory investigations demonstrated markedly elevated C-reactive protein levels despite a normal white blood cell count. Plain abdominal radiography showed multiple air–fluid levels consistent with small bowel obstruction. Contrast-enhanced computed tomography revealed an inflamed appendix measuring 12 mm in diameter with an appendicolith, periappendiceal fat stranding, and focal fluid collection, indicating acute appendicitis complicated by mechanical intestinal obstruction. The patient underwent a laparoscopic appendectomy with drainage of an appendicular abscess, resulting in resolution of the obstruction. Histopathological examination confirmed acute suppurative appendicitis with gangrenous changes. The postoperative course was uneventful. Conclusion: Mechanical small bowel obstruction secondary to acute appendicitis is an uncommon but clinically significant condition that may mask the typical presentation of appendicitis. Early recognition and appropriate imaging are essential for timely diagnosis and surgical management, which are associated with favorable outcomes.
Keywords
Acute appendicitis ; Small bowel obstruction ; Mechanical intestinal obstruction ; Acute abdomen ; Laparoscopic appendectomy
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