Secondary torsion of vermiform appendix with mesoappendiceal lipoma.
A torsion of the vermiform appendix with a mesoappendiceal lipoma is a rare condition. It is also a rare cause of acute abdomen, as such, the condition is diagnosed during surgery. This case report presents a 70-year-old male patient with lower right abdominal pain and signs of acute abdomen with an increased peripheral blood leukocyte count. An ultrasound examination revealed a mass of 9.6 cm2, which was suggested to be a perityphlitic abscess. An emergency operation was indicated, as the patient had clinical signs of acute abdomen. Laparotomy via a pararectal incision revealed the cause of the pain to be a torsion of the vermiform appendix caused by a mesoappendiceal lipoma. The apex of the appendix was perforated, which caused circumscript peritonitis. Both an appendectomy and an extirpation of the tumor were performed, and a surgical drain was placed in the wound, yielding an excellent postoperative clinical outcome.
Damir Grebic, MD, PhD, Department of Surgery, Clinical Hospital Center Rijeka, School of Medicine, University of Rijeka, Kresimirova 42, Rijeka, Croatia, T: 051/ 658-684, 091/5370634, F: 051/ 213-734, damir.grebic@medri.uniri.hr.
Damir
D
Grebic
Franjo
F
Lovasic
Indira
I
Benjak
Ingrid
I
Lovasic
D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D001062:Appendectomy / Q000379:methods; D001065:Appendix / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007813:Laparotomy / Q000379:methods; D007958:Leukocyte Count; D008067:Lipoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology