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Laparoscopic surgery for mechanical small bowel obstruction due to appendicitis

Andrew Mueller, MD1, Carl Tadaki, MD2. 1University of Hawaii, 2Straub Medical Center

A 53 year old male with no prior history of abdominal surgery presented to the emergency department with a two day history of abdominal pain, nausea and vomiting, and absent flatus and bowel movements. During the initial physical exam the patient was found to have right lower quadrant abdominal pain. Laboratory workup revealed a leukocytosis to 13,600. The patient underwent abdominal two-view x-ray which was suggestive of small bowel obstruction. The patient then underwent CT scan of the abdomen and pelvis, which demonstrated small bowel obstruction with a closed loop and or internal hernia. CT scan also showed wall thickening and small amount of free fluid. The appendix was not seen on CT scan. The patient was consented for exploratory laparoscopy. Intraoperatively the patient was found to have the appendix wrapped around the distal ileum causing a mechanical obstruction. This was freed and an appendectomy was performed. The patient was discharged in good health and tolerating a regular diet on post operative day one.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94701

Program Number: V218

Presentation Session: Video Loop Day 1

Presentation Type: VideoLoop

51

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