Appendicitis should therefore be considered in cases of mechanical intestinal obstruction of unknown cause, especially in the elderly. Role of CT in detecting appendix as the cause of intestinal obstruction is questionable. During the phase of active appendicular inflammation there may be appropriate CT findings. However these findings may not be present in patients who develop intestinal obstruction after the resolution of appendicitis. Thus pointing
out appendix as the cause would not be possible. However CT is very useful to detect bowel ischemia, intestinal obstruction and ascites when present. Early diagnosis and intervention is very important in strangulation of bowel. Whenever features of intestinal obstruction predominate, we recommend using a mid line vertical incision as the exact pathological type cannot be determined. Mc Burney’s incision may suffice if the obstruction is Adynamic or Mechanical. However it would be inadequate and even disastrous if Selleck 5-Fluoracil strangulation or mesenteric ischemia is present, as these are likely to be overlooked {Selleck Anti-diabetic Compound Library|Selleck Antidiabetic Compound Library|Selleck Anti-diabetic Compound Library|Selleck Antidiabetic Compound Library|Selleckchem Anti-diabetic Compound Library|Selleckchem Antidiabetic Compound Library|Selleckchem Anti-diabetic Compound Library|Selleckchem Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|buy Anti-diabetic Compound Library|Anti-diabetic Compound Library ic50|Anti-diabetic Compound Library price|Anti-diabetic Compound Library cost|Anti-diabetic Compound Library solubility dmso|Anti-diabetic Compound Library purchase|Anti-diabetic Compound Library manufacturer|Anti-diabetic Compound Library research buy|Anti-diabetic Compound Library order|Anti-diabetic Compound Library mouse|Anti-diabetic Compound Library chemical structure|Anti-diabetic Compound Library mw|Anti-diabetic Compound Library molecular weight|Anti-diabetic Compound Library datasheet|Anti-diabetic Compound Library supplier|Anti-diabetic Compound Library in vitro|Anti-diabetic Compound Library cell line|Anti-diabetic Compound Library concentration|Anti-diabetic Compound Library nmr|Anti-diabetic Compound Library in vivo|Anti-diabetic Compound Library clinical trial|Anti-diabetic Compound Library cell assay|Anti-diabetic Compound Library screening|Anti-diabetic Compound Library high throughput|buy Antidiabetic Compound Library|Antidiabetic Compound Library ic50|Antidiabetic Compound Library price|Antidiabetic Compound Library cost|Antidiabetic Compound Library solubility dmso|Antidiabetic Compound Library purchase|Antidiabetic Compound Library manufacturer|Antidiabetic Compound Library research buy|Antidiabetic Compound Library order|Antidiabetic Compound Library chemical structure|Antidiabetic Compound Library datasheet|Antidiabetic Compound Library supplier|Antidiabetic Compound Library in vitro|Antidiabetic Compound Library cell line|Antidiabetic Compound Library concentration|Antidiabetic Compound Library clinical trial|Antidiabetic Compound Library cell assay|Antidiabetic Compound Library screening|Antidiabetic Compound Library high throughput|Anti-diabetic Compound high throughput screening| [3]. In case of intestinal obstruction without known cause, as with the second group, midline vertical incision is definitely the approach of
choice. There is no material available as to the role of laparoscope either with the diagnosis or management of intestinal obstruction due to appendicitis. It may be useful since it is diagnostic as well as therapeutic. There is less tissue handling; better cosmesis and a shorter post op stay [12]. Conclusion Intestinal obstruction due to appendicitis may be of 4 types: Adynamic, Mechanical, Strangulation and due to Mesenteric Ischemia. Clinically and radiologically it may not be possible to differentiate these types. Clinically the presentation may be predominantly
appendicitis or predominantly intestinal obstruction. In the second group it is important to rule out appendicitis by careful re-evaluation. Role of CT in detecting appendix as the cause of intestinal obstruction is questionable. Midline vertical incision would be the approach of choice whenever features of intestinal obstruction predominate, even if appendicitis is known to be the etiological agent. Whenever Sinomenine there is intestinal obstruction associated with acute appendicitis, it may not always be Adynamic and the rarer and more dangerous forms should always be kept in mind. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. References 1. Hotchkiss LuciusW: Acute intestinal obstruction following appendicitis. a report of three cases successfully operated upon. Ann Surg 1901, 34:660–677.CrossRefPubMed 2. Forbes Hawkes: The prevention of intestinal obstruction following operation for appendicitis. Ann Surg 1909, 49:192–207. 3. Croome RRM, Knox J: Large bowel obstruction with acute appendicitis.