The presence of a closed-loop obstruction of the ileum due to an appendical knot is thought to be unusual enough to warrant its report.
A 43-year-old male Korean civilian was admitted to "D" Medical Company of the First Marine Division on the evening of luly 17, 1954, with a complaint of abdominal pain of about 24 hours' duration. Approximately one hour after eating his evening meal on luly 16, 1954, he noted the sudden onset of epigastric "cramping" pain, which was followed by frequent episodes of vomiting. About one-half hour after the pain commenced, it radiated to the upper right quadrant and later localized in the right lower quadrant. The pain was described as constant and severe. The patient was seen that night by a Korean doctor who made a diagnosis of "appendicitis" and administered two injections, supposedly of morphine and penicillin. The symptoms became progressively worse throughout the next
Mikal S, Byers JA. CLOSED-LOOP OBSTRUCTION OF THE ILEUM DUE TO AN APPENDICAL KNOTREPORT OF A CASE. JAMA. 1956;160(1):49–50. doi:10.1001/jama.1956.02960360051009c