Vascular complications during appendectomy: severe adhesion of the appendix to the right iliac artery: a case report

Appendicitis is a common cause of acute abdomen. Rarely, it may form adhesions to nearby structures, complicating surgeries, especially when involving vascular structures such as the internal iliac artery, potentially causing severe intraoperative hemorrhage. A 65-year-old Middle Eastern male presen...

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Bibliographic Details
Published in:Journal of medical case reports 2024-10, Vol.18 (1), p.460-9, Article 460
Main Authors: Hosseinzadeh, Ahmad, Rezaeibana, Hoora, Khosravi, Mohammadreza, Sourani, Armin, Yazdanshenas, Hadis, Shahriarirad, Reza
Format: Article
Language:English
Subjects:
Aged
Anorexia nervosa
Appendectomy
Appendicitis
Appendicitis - surgery
Appendix
Appendix - surgery
Blood Loss, Surgical
Complications and side effects
Humans
Iliac artery
Iliac Artery - diagnostic imaging
Iliac Artery - surgery
Ligation
Male
Tissue adhesions
Tissue Adhesions - surgery
Treatment Outcome
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Summary:Appendicitis is a common cause of acute abdomen. Rarely, it may form adhesions to nearby structures, complicating surgeries, especially when involving vascular structures such as the internal iliac artery, potentially causing severe intraoperative hemorrhage. A 65-year-old Middle Eastern male presented with abdominal pain and anorexia for 5 days. Examination and imaging confirmed acute appendicitis with complications. Additionally, a large pelvic mass was noted. During surgery, severe bleeding was encountered due to an adhesion between the appendix and the right internal iliac artery, managed by ligating the artery. The patient recovered well and was discharged in stable condition. Histopathology confirmed the diagnosis. This case highlights a rare vascular complication of appendectomy due to abnormal adhesions between the appendix and the internal iliac artery, associated with a large pelvic mass. This study emphasizes the need for thorough preoperative evaluation and careful surgical planning in patients with unusual anatomical variations or specific underlying conditions such as neurofibromatosis. Early recognition and strategic management of vascular adhesions are essential to optimize patient outcomes in appendectomies complicated by such rare scenarios.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-024-04794-8