Acute appendicitis complicated by portomesenteric venous thrombosis: A diagnostic and therapeutic challenge - A case report.

Acute appendicitis complicated by mesenteric vein thrombosis (MVT) is an uncommon yet potentially life-threatening condition. A delay in diagnosis or treatment of MVT can result in bowel ischemia and infarction. We present the case of a 34-year-old female who presented with high-grade fever, persistent vomiting, and acute abdominal pain. Laboratory investigations revealed leucocytosis and abnormal liver function tests. Contrast-enhanced CT (CECT) of the abdomen demonstrated hepatosplenomegaly, gangrenous appendicitis, and thrombus formation in the ileocolic vein, proximal superior mesenteric vein, and the left portal vein branch. The patient underwent an emergency appendectomy and was managed with anticoagulant therapy. This case report highlights the crucial role of family physicians, often the first point of contact, in recognizing potentially serious abdominal conditions. Early identification of atypical presentations and timely referral for appropriate imaging, such as contrast-enhanced CT, can be lifesaving by enabling prompt diagnosis and management of underlying complications like mesenteric vein thrombosis.