Torsion of Appendix Misdiagnosed as Ovarian Tumor / 대한내시경복강경외과학회지

ABSTRACT

Acute appendicitis is the most common cause of an acute abdomen. But torsion of the appendix is a rare disorder that causes abdominal symptoms that are indistinguishable from acute appendicitis. So, making the preoperative diagnosis of torsion of the appendix is difficult. In 1918, Payne et al. reported the first case of torsion of the appendix in a 37 years old woman. Since then, more than thirty cases have been reported. Torsion of the appendix can occur at any age & gender. Here, we report on a case of secondary torsion of appendix with mucinous cystadenoma in a 52 year-old woman, which was initially thought to be a right adnexal mass. Abdomen CT showed an 11x5 cm sized intra-abdominal mass growing along the right fallopian tube. On the small bowel series, an extra-luminal mass was found and this was pushing aside the small intestine. We performed diagnostic laparoscopic exploration and found inflammation of appendix with torsion. It was twisted 720degrees in a clockwise direction with ischemic change. The histological result was mucinous cystadenoma.