Preoperative Diagnosis of Appendiceal Torsion—A Case Report—

Abstract

The patient was a 55-year-old man who came to our emergency department with a complaint of epigastric discomfort, but no tenderness of the abdomen. The laboratory tests showed inflammatory reaction. Despite these negative findings, an abdominal contrast-enhanced computed tomography scan showed a cystic lesion with marked caliber change at the root of the appendix, which was a clear-cut sign of appendiceal torsion. At emergency surgery, the appendix was found to be twisted 180 degrees at the root, and it was dark-blue in color. An appendectomy was safely carried out after release of the torsion. The patient had a good postoperative course.

Appendiceal torsion is a rare condition for which preoperative diagnosis is difficult, and perforation is not an uncommon complication. It is necessary to include appendiceal torsion in the differential diagnosis of appendicitis, and not to overlook its characteristic findings on CT.