Abstract
This article reports a rare case of a patient with acute appendicitis in whom ileal perforation was incidentally found during surgery. The patient was admitted with typical symptoms of right lower quadrant abdominal pain and was diagnosed with acute appendicitis based on physical examination, laboratory tests, and CT imaging findings. An emergency laparoscopic exploration was performed. During the operation, two perforations in the ileum, 10 cm away from the ileocecal junction, were unexpectedly discovered. The patient underwent perforation repair combined with appendectomy. Postoperative recovery was uneventful, and no complications were observed during a 2-month follow-up. This case highlights the clinical importance of considering the possibility of coexisting acute abdominal conditions in patients with appendicitis and emphasizes the significance of systematic intraoperative exploration, providing a reference for the diagnosis and treatment of similar cases.