case_images: PMC11821411_01
case_images: PMC11821411_02
case_images: (A and B): (A) Intraoperative image demonstrating the inflamed appendix (blue arrows) wrapping tightly around a segment of distal ileum, forming a closed-loop obstruction near the ileocecal valve. The appendix tip adheres to the cecum, contributing to a tourniquet-like effect. (B) A closer view of the same intraoperative findings, highlighting the ischemic and necrotic appearance of the affected distal small bowel segment (white arrows) caused by the knot formed by the appendix, which impaired vascular flow to the segment.
case_images: gr1.jpg
case_images: PMC11821411_02_gr1.jpg
case_images: f0005
case_images: Intraoperatively, 1.5 l of hemorrhagic peritoneal fluid was evacuated, and an inflamed appendix was found wrapped around a 60 cm segment of distal ileum near the ileocecal valve, forming a closed-loop obstruction (Fig. 1).