Torsion of the Diverticulum of the Appendix

Abstract

We report a case of a 1-year-old girl, operated on due to the symptoms of acute appendicitis. Torsion, necrosis and perforation of the large diverticulum of the appendix vermiformis, causing peritonitis were found during the operation. The complete luminary connection between appendix and the diverticulum was proved. Although appendix vermiformis itself was not the reason for the peritonitis, it was removed together with the diverticulum. The child’s recovery after the operation was stable. The morphology revealed that the diverticulum of appendix vermiformis generally possessed features typical of a large intestine columnar epithelium, while its other layers, including a muscular layer and an irregularly expanded sub-mucosal layer, remained similar to the wall of the appendix. We suggest that the torsion of the true congenital diverticulum of the vermiform appendix mimicked acute appendicitis and caused peritonitis in the above-mentioned girl.