Mechanic intestinal obstruction - a possible presentation of perforated appendicitis

A 61-year-old presented with diffuse abdominal pain, diarrhea, vomiting and fever. On the initial diagnosis of gastroenteritis the patient received th e antibiotic ofloxacine for one week. On admission plain abdominal radiogra ph suggested a mechanic intestinal obstruction. In computed tomography a co nglomerate tumor in the ileocecal region was seen and the patient underwent laparotomy. The conglomerate tumor was mobilized and an abscess opened, wh ich was caused by a perforated appendicitis. After the operation the patien t improved immediately and had an uneventful postoperative course. He was r eleased and did not suffer from gastrointestinal symptoms the following 10 months of follow-up. The present cave shall set forth that perforated appen dicitis can clinically present as intestinal observation. Although a rare c omplication, perforated appendicitis should therefore even be considered in cases of mechanic intestinal obstruction of unknown cause.