CASE REPORT
An 86 years old woman, with history of hypertension, diabetes and dyslipidaemia, was
operated for acute appendicitis confirmed by abdominal ultra-sound. Intraoperative
exploration (through a McBurney incision) revealed a gangrenous appendix with oedematous
and slightly cyanotic ileo-caecal junction. The unusual aspect of the latter was assigned to local inflammation and usual appendectomy was performed. Three days later, she presented
dyspnea and hypoxemia. Abdomino-thoracic angioscan showed a proximal pulmonary
embolism with a circumferential thickening of the caecum and terminal ileum without any
local collection. Heparin therapy was started and antibiotics were prescribed. Seven days later, she had a new abdominal scan because of abdominal distension with diffuse abdominal
tenderness, fever and hyper leucocytosis. It suggested a mesenteric venous infarction as it
showed superior mesenteric vein thrombosis (Figures 1 and 2) associated to circumferential
thickening and default enhancement of the caecum and terminal ileum (Figure 1). The patient
had a respiratory failure and died before we could perform intestinal resection.