Torsion of the Vermiform Appendix

Clinical features:

(1) The patient presents with acute abdominal pain resembling acute appendicitis.

(2) The diagnosis of torsion is usually made by the surgeon based on the gross appearance at surgery.

(3) Other diagnoses are excluded.

The torsion is more counterclockwise but can be clockwise.

Resection of the appendix is curative and prevents recurrence.

Risk factors for torsion include:

(1) mucinous tumor the appendix

(2) fecalith

(3) long appendix

(4) narrow base

(5) fan-shaped mesoappendix

(6) pelvic position for the appendix

(7) adhesions