抄録
Torsion of the vermiform appendix in a 2 1/3-year-old boy, who appears to be the youngest patient with this disease in the world literature, is reported. He had no previous history of abdominal pain. He began to complain of abdominal pain about 30 minites after standing on his hands for the first time in his life. Two days later, he was admitted to our hospital because of severe intermittent abdominal pain. Tenderness of his right lower abdomen associated with a WBC count of 23100/cmm and an enlarged appendix as seen in the ultrasonogram led us to perform a laparotomy under the diagnosis of acute appendicitis. The vermiform appendix showed clockwise torsion of 360°at its root and a gangrenous appearance. There was no adhension of the appendix to the surrounding tissue, and so release of the torsion and an appendectomy were easily performed. No fecalith or inflammation of the appendix was observed. The postoperative course of the patient was uneventful. Although anatomical or pathological causes of torsion of the appendix are still unknown, STANDING ON HIS HANDS was suggested as an important etiological factor in this case.
