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28 March 2018 : Case report  Australia

Torsion of the Vermiform Appendix: A Case Report and Review of Literature

Rare disease

Wan Amir Wan HassanABCDEFG, Yeng Kwang TayABCDEF, Marjan GhadiriDE

DOI: 10.12659/AJCR.908725

Am J Case Rep 2018; 19:365-368

Abstract

BACKGROUND: Torsion of the vermiform appendix is a rare condition that presents with symptoms analogous to those of common acute appendicitis; therefore, it is often diagnosed during surgery. It was first described by Payne et al. in 1918. Since then, there has been wide recognition of a primary and a secondary form of the condition, affecting both the pediatric and adult populations. We present a case of an adult patient and conducted a literature review in the adult demographic.

CASE REPORT: We report the case of a 30-year-old man who presented with clinically acute appendicitis. Laparoscopically, we diagnosed a torsion of the vermiform appendix secondary to a mucocele process. Histology confirmed a low-grade mucinous cystoadenoma, with a hemorrhagic necrosis of the wall, in keeping with torsion.

CONCLUSIONS: Torsion of the vermiform appendix is a rare condition that presents similar to acute appendicitis, and therefore is often diagnosed intraoperatively. Since first described, 33 cases in adults were identified in the English literature, and recognition of a primary or secondary form has emerged. Preoperative radiological imaging is rarely useful in diagnosis. To the best of our knowledge, this is the eighth reported case in the English literature of a torsion of the vermiform appendix secondary to a mucinous cystoadenoma.

Keywords: Appendix, Cystadenoma, Mucinous, Torsion Abnormality

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923