Discussed is a patient with both a mechanical and paralytic ileus as a result of a gangrenous appendicitis with perforation and a circumscribed peritoneum and incarceration of an inguinal hernia on the opposite side. The patient's heart too was suffering a disease. The postoperative course was difficult. It was complicated by pleural hemorrhaging and by lung infiltrations because of embolisms. With an emergency operation involving the entire team, the patient was saved. Although the pathology is rare, the patient was saved. Although the pathology is rare, the authors discuss its significance.

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