Torsion of the vermiform process: clinical observations

   Introduction. Torsion of the appendix is an extremely rare pathology in both adults and children. In this article, the authors report about two cases of appendix torsion which were revealed intraoperatively.

   Case description. Clinical observation 1: A 2-year-old boy was admitted to the surgical department with suspected acute appendicitis. On examination, the entire abdominal region was painful, the symptom of passive muscle defense was noted on the right. Ultrasound examination revealed changes in the appendix. Intraoperatively, torsion of the appendix was detected. Laparoscopic appendectomy was performed. The postoperative course was uneventful. Clinical observation 2: A 5-year-old boy was admitted to the surgical department with complaints of abdominal pain. Physical examination revealed the clinical picture of acute abdomen. At ultrasound examination, signs of altered appendix were seen. During diagnostic laparoscopy, torsion of the appendix was detected. Laparoscopic appendectomy was performed. The postoperative course was uneventful.

   Conclusion. The discussed two clinical cases indicate the necessity to include torsion of the appendix in the list of diagnoses for differential diagnostics in case of acute abdomen.