Secondary torsion of vermiform appendix with mesoappendiceal lipoma

Abstract

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.