Background: 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.
Case Presentation: 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.
Discussion and Conclusion: 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.