:
Septic thrombophlebitis of the Superior Mesenteric Venous (SMV) is rarely accompanied by appendicitis, and
symptoms are atypical, so the diagnosis is commonly delayed, resulting in it is associated with high mortality. We report a
case of neglected SMV septic thrombophlebitis is caused by appendicitis. The patient represented with fever, vague abdominal pain without rebound tenderness, and history of the consumption of contaminated water. Antibiotic initiated due to
suspicious typhoid fever. Then typhoid fever was ruled out. Computed tomography (CT) scans revealed micro-abscess
forming complicated appendicitis and the thrombus in SMV. The patient underwent a laparoscopic appendectomy, during
which retrocecal gangrened perforated appendix with a 2×2 cm abscess was drained. Based on positive culture with ESBL
organism meropenem was initiated. Appendectomy and treatment with broad-spectrum antibiotics and anticoagulation led to
a full recovery.
Peritonitis in a patient with typhoid fever
