When the cure turns cold: ischaemic appendicitis as a rare complication of ileocolic embolization

In many tertiary centers with rapid access and expertise, IR angioembolization is now frequently employed as first line treatment for control of active and potentially life-threatening hemorrhage, rather than endoscopic or surgical management. We present an extremely rare case of acute perforated appendicitis following ileocolic angioembolization, for the management of major colonic bleeding. Although acute appendicitis is a very common general surgical pathology, its occurrence secondary to angioembolization, representing an ischemic complication, has only been described once before in the literature. It is thus important to maintain close clinical observation for signs of ischemia following gastrointestinal embolization procedures, particularly when performed in the ileocolic region due to its limited collateral blood supply. While non-operative management was successfully pursued, as more cases are published in the literature, a consensus guideline can ideally be developed to determine the optimal management for this rare subset of patients.