Appendiceal tie syndrome causing small bowel obstruction in 30 year old woman.

Appendicitis is a common cause of acute abdominal emergencies, but mechanical small bowel obstruction due to appendicealtie syndrome is rare. We present a 30-year-old healthy female patient with a typical presentation of febrile intestinal obstruction with multiple central air-fluid levels on an erect abdominal X-ray. During laparotomy, a phlegmonous appendix was found encircling and strangulating the terminal ileum with no signs of bowel ischemia. A simple appendectomy was performed, relieving the obstruction. Postoperative recovery was uneventful aside from a superficial wound infection. Appendiceal tie syndrome is a rare entity that can present as febrile small bowel obstruction in patients of any age group. The diagnostic value of advanced imaging remains uncertain and clinical suspicion is of paramount importance. Timely surgical intervention leads to improved outcomes. Simple appendectomy may result in resolution of obstruction and clinical symptoms if affected bowel segments are viable despite delayed presentation.