Rare case of an abdominal mass presenting as acute abdomen: Torsion of the vermiform appendix

Abstract

Torsion of the vermiform appendix is a rarely observed acute abdominal emergency. The clinical manifestations are similar to acute appendicitis. It should be included in the differential diagnosis if a patient presents with intermittent abdominal pain and an acute abdominal emergency. Here, we describe a 4-year-old male patient with a mass located in the right lower abdominal quadrant, whose clinical findings were consistent with an acute abdomen. The gangrenous appendix was found in the pelvic cavity and its stump was twisted clockwise. A 1.5-cm fecalith was detected in the appendix lumen and appendectomy was performed.

Laparoscopic Treatment of Vermiform Appendix Torsion

“…The condition has a male preponderance in children. [2] In our case, physical examination and laboratory tests indicated acute appendicitis and at surgery appendix was found gangrenous.…”

“…From the first description by Payne in 1918, approximately 17 cases have been reported in children so far. [1][2][3][4] We report a case torsion of the VA which was managed laparoscopically.…”

Twists and turns: A rare case of appendiceal torsion unraveled

“…Nearly half of the cases involved counterclockwise torsion. The degree of torsion ranged between 180° and 1080° degrees (Kilincaslan et al, 2013). An appendicular volvulus case has been diagnosed pre-operatively with radiological findings by an abdominal CT, which showed a dilated appendix, peri-appendiceal fluid, no fecalith, and twisting of the base of the appendix (Hashimi and Barthel, 2021).…”

“…Alfarsi MA, Zaky MKS, Qari AS, Elyas A. bacterial invasion, has been reported to lead to autoamputation and misdiagnosed with appendicular agenesis (Val-Bernal et al, 1996;Kilincaslan et al, 2013). Acute appendicitis and primary acute torsion of the vermiform appendix are identical before surgery (Val-Bernal et al, 1996).…”

A review of the studies about appendicitis of the Turkish Pediatric Surgical Centers and a preliminary study to form a publishing index for pediatric appendicitis.

“…Torsiyon 3 olguda saat yönünde, birinde ise saatin aksi yöndedir. 1 olguda fekalit bulunmuştur (133,157,183,186) .…”