Volvulus of the appendix: a case report

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Abstract

Volvulus of the appendix is an uncommon phenomenon in children (J Can Med Assoc.1966;95:926-927). Only a few reports exist in the literature concerning this subject. We describe a 2-year-old child who presented with right lower quadrant abdominal pain and was initially diagnosed as ruptured appendicitis with abscess. Attempt at computed tomography–guided drainage failed to produce purulent drainage, and the child was taken to the operating room for diagnostic laparoscopy. Operative findings revealed a volvulus of the appendix, and a laparoscopic appendectomy was performed.

Section snippets

Case report

A previously healthy 2-year-old boy presented to the hospital with 2 days of worsening abdominal pain and 3 episodes of vomiting. On physical examination, the child was febrile to 38.3°C, alert, and irritable with stable vital signs. The abdomen was firm, tender, and nondistended. Laboratory studies were normal except for leukocytosis of 19,000/mm3 with predominant neutrophils (76%). The patient was admitted to the hospital with a presumed diagnosis of perforated appendicitis. Abdominal

Discussion

A volvulus is a type of intestinal obstruction in which a portion of intestine is abnormally twisted on itself. Although there are many anomalies leading to intestinal rotation and fixation, these most often include acute and chronic midgut volvulus, acute and chronic duonenal obstruction secondary to bands, internal hernias, and cecal/sigmoid volvulus [1], [2]. Volvulus of the appendix represents an uncommon phenomenon [3]. A review of the Entrez PubMed literature documented that only 25 cases

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