Modified Graham patch repair for cecal perforation: A case report

Introduction and importance: Acute appendicitis is a common cause of acute abdomen worldwide. The complications associated with it can sometimes be unpredictable and pose a dilemma in the management of such complications. Case presentation: A case of 18 year female with complaints of right iliac fossa pain and vomiting was diagnosed clinically as acute appendicitis and underwent emergency open appendectomy where a cecal perforation was encountered intra-operatively for which a Modified Graham 's Patch Repair was done. Clinical discussion: Acute appendicitis can sometimes present with complications like perforation, among which cecal perforation is rare and difficult to diagnose in the initial setting. Perforated appendicitis or colon can increase morbidity and mortality significantly. High degree of suspicion and early surgical approach can lead to identification of rare complications, which can still pose a surgical dilemma on the approach of management. Conclusion: Cecal perforation in suspected acute appendicitis is a rarely encountered intra operative complication. Management approaches can range from less invasive suture with omental patch repair to more invasive right hemicolectomy.