{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:17:09Z","timestamp":1792513029433,"version":"4.5.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Perforated appendicitis causing mechanical small-bowel obstruction is rare in pediatric patients and can mimic common gastrointestinal illnesses, delaying definitive treatment. We report the case of a 3-year-old girl with 5\u00a0days of nonbilious vomiting, diarrhea, and high-grade fever, initially managed as gastroenteritis. Ongoing abdominal distension and failed conservative management prompted plain radiographs showing dilated small-bowel loops and air\u2013fluid levels. Subsequent magnetic resonance imaging revealed a periappendiceal abscess compressing the distal ileum at a transition point. Urgent laparoscopy, converted to a minilaparotomy, confirmed a perforated appendix with dense adhesions tethering the ileum, necessitating appendectomy, adhesiolysis, and peritoneal lavage. The patient\u2019s postoperative recovery was uneventful, with normalization of inflammatory markers and restoration of bowel function. This case highlights the importance of considering atypical appendicitis in prolonged gastrointestinal symptoms, the utility of magnetic resonance imaging in diagnosis, and the need for prompt surgical intervention to prevent serious complications.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf628","type":"journal-article","created":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T11:51:03Z","timestamp":1753530663000},"source":"Crossref","is-referenced-by-count":1,"title":["Perforated appendicitis presenting as mechanical bowel obstruction in a pediatric patient: a rare diagnostic challenge"],"prefix":"10.1093","volume":"2025","author":[{"given":"Mohammed","family":"Al Blooshi","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery and Urology , Al Jalila Children\u2019s Specialty Hospital, 6th Street, Al Jaddaf, Dubai 300100,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaf Binu","family":"Manaf","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics , Al Jalila Children\u2019s Specialty Hospital, 6th Street, Al Jaddaf, Dubai 300100, Emirate of Dubai,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munir","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology , Al Jalila Children\u2019s Specialty Hospital, 6th Street, Al Jaddaf, Dubai 300100,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoun","family":"Al Marzouqi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology , Al Jalila Children\u2019s Specialty Hospital, 6th Street, Al Jaddaf, Dubai 300100,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"2025081313080739100_ref1","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1097\/SLA.0000000000002188","article-title":"The global incidence of appendicitis: a systematic review of population-based studies","volume":"266","author":"Ferris","year":"2017","journal-title":"Ann Surg"},{"key":"2025081313080739100_ref2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/1749-7922-4-34","article-title":"Appendicitis as a cause of intestinal strangulation: a case report and review","volume":"4","author":"Bhandari","year":"2009","journal-title":"World J Emerg Surg"},{"key":"2025081313080739100_ref3","first-page":"94","article-title":"Intestinal obstruction caused by appendicitis: a systematic review","volume":"7","author":"Makama","year":"2017","journal-title":"J West Afr Coll Surg"},{"key":"2025081313080739100_ref4","doi-asserted-by":"publisher","DOI":"10.3329\/TAJ.V30I1.39122","article-title":"Risk factors of perforation of appendix and unfavorable outcome in delayed presentation of acute appendicitis: a cross-sectional analysis","volume":"30","author":"Hakim","year":"2018","journal-title":"TAJ: Journal of Teachers Association"},{"key":"2025081313080739100_ref5","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s12262-020-02683-0","article-title":"Intestinal obstruction due to acute appendicitis","volume":"83","author":"Krishna","year":"2021","journal-title":"Indian J Surg"},{"key":"2025081313080739100_ref6","first-page":"261","article-title":"Mechanical small bowel obstruction due to an inflamed appendix wrapping around the last loop of ileum","volume":"26","author":"Assenza","year":"2005","journal-title":"G Chir"},{"key":"2025081313080739100_ref7","doi-asserted-by":"publisher","first-page":"911","DOI":"10.2214\/AJR.16.17413","article-title":"Diagnostic accuracy of MRI versus CT for the evaluation of acute appendicitis in children and young adults","volume":"209","author":"Kinner","year":"2017","journal-title":"AJR Am J Roentgenol"},{"key":"2025081313080739100_ref8","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1007\/s004640020072","article-title":"Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis","volume":"15","author":"Piskun","year":"2001","journal-title":"Surg Endosc"},{"key":"2025081313080739100_ref9","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1097\/SLA.0b013e3181ad64a7","article-title":"Bowel obstruction following appendectomy: what is the true incidence?","volume":"250","author":"Leung","year":"2009","journal-title":"Ann Surg"}],"container-title":["Journal of Surgical Case 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