An 81-year-old man presented with a 1-day history of right iliac fossa pain that radiated to the left iliac fossa. Vital signs were normal. Examination revealed abdominal distension with peritonism. An abdominal x-ray showed small bowel obstruction, and a computed tomography scan suggested a small bowel volvulus.
The average length of the adult appendix is 7.5 cm in men and 6.7 cm in women (SD, 2.1 cm; range, 2–26 cm).1 Small bowel obstruction secondary to “appendiceal tourniquet” is extremely rare, with only 12 cases previously reported.2,3
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- Richard H Riley1
- Richard J Martin2
- 1 Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, WA.
- 2 Department of Surgery, Sir Charles Gairdner Hospital, Perth, WA.
Correspondence: richard.riley@health.wa.gov.au
- 1. Raschka S, Raschka C. [On the relationship between body dimensions and appendix length] [German]. Anthropol Anz 2008; 66: 67-72.
- 2. O’Donnell ME, Sharif MA, O’Kane A, Spence RA. Small bowel obstruction secondary to an appendiceal tourniquet. Ir J Med Sci 2009; 178: 101-105.
- 3. Assenza M, Ricci G, Bartolucci P, Modini C. Mechanical small bowel obstruction due to an inflamed appendix wrapping around the last loop of ileum. G Chir 2005; 26: 261-266.
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