This is the report of a case of a 29 year-old male patient, who
presented with signs and symptoms of acute abdomen. A diagnosis of acute
– on – chronic appendicitis was made. The patient was resuscitated and
prepared for emergency appendectomy. However, at operation it was
discovered that the patient had ileo-caecal volvulus. The volvulus was
de-tortioned and caecopexy was performed to prevent recurrence even
though there was no redundant mesentery. The appendix itself was not
found at the usual site or anywhere else in the abdomen. The abdomen was
closed and the patient recovered and was discharged on the tenth
postoperative day without complications. This presentation is unusual,
and the where about of the appendix is a matter of conjecture (perhaps
it had sloughed off following episodes of recurrent acute appendicitis).
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