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March 28, 1977

Torsion of Vermiform Appendix

JAMA. 1977;237(13):1312-1313. doi:10.1001/jama.1977.03270400016009

To the Editor.—  Torsion of the appendix is a very uncommon cause of acute abdominal symptoms. Because of the rarity of this condition, the following case is described.

Report of a Case.—  A 35-year-old man was hospitalized with severe, continuous abdominal pain of five days' duration. It intensified nine hours before admission, localized in the right lower quadrant, and was accompanied by vomiting. There was no notable past medical history; specifically, the patient denied constipation and use of laxatives or enema.On admission, his pulse was 84 beats per minute; temperature, 37.3°C; blood pressure, 110/76 mm Hg; and respirations, 18/min. There was marked tenderness with rebound in the right lower quadrant of the abdomen. The bowel sounds appeared decreased. Rectal examination was unrevealing. Results of the remainder of the physical examination were unremarkable. Pertinent laboratory data included a WBC count of 10,700/cu mm, with 86% polymorphonuclear leukocytes. Chest and plain