Introducere: torsiunea apendicelui vermiform (TAV) reprezinta un fenomen rar si inexplicabil caracterizat prin rotatia AV de-a lungul axei sale longitudinale, ce poate provoca sindromul abdominal acut. Scop: Trecerea in revista a literaturii de profil si analiza datelor demografice (varsta si predilectia sexuala), particularitatilor clinice si optiunilor de tratament in caz de TAV. Material si metoda: Examinarea publicatiilor din PubMed si Google Scholar Search conform cuvintelor-cheie: “acute abdomen”, “vermiform appendix”, “torsion”, “appendectomy” cu identificare a 40 de cazuri de TAV la adulti raportate in perioada aa. 1918-2020. Rezultate: Varsta medie – 42.03±2.83 ani, raportul B:F=1.2:1. Gradul de rotatie 180°–1800°, predomina miscarea contrar acelor de ceasornic, punctului de torsiune fiind situat la distanta 1.0 cm de la baza apendicelui sau mai distal. Sunt descrise mai multe etiologii ale TAV: cauze primare–15(37.5%) sau unele stari patologice, ca mucocel apendicular–8(20%),chiastadenom muconos–7(17.5%), lipom apendicular–2(5%), apendicoliti–2(5%), altele–6(15%). Majoritatea pacientilor se prezinta cu semnele clinice sugestive pentru apendicita acuta, printre care durere in cadranul inferior drept al abdomenului, voma, greata, febra, anorexie. Testele de laborator si examinarile paraclinice (radiografie abdominala, examen ultrasonografic, tomografie computerizata, rezonanta magnetica nucleara) sunt nespecifice, ca rezultat diagnosticarea preoperatorie este dificila. Apendicectomia de urgenta, deschisa (n=32;80%) sau laparoscopica (n=8;20%), reprezinta metoda optimala de tratament, conduita nonoperatorie fiind contraindicata din cauza riscului inalt de necroza si perforatie. Concluzii: TAV este o afectiune rara, ce are simptome similare cu cele ale apendicitei acute, si trebuie inclusa in diagnosticul diferential la un pacient cu dureri in regiunea inghinala dreapta.

Introduction: Appendicular torsion (AT) is a rare and unexplained phenomenon characterized by a twisting of the appendix along its longitudinal axis that causes acute abdomen syndrome. Purpose of the study: Searching for specialized literature and analysis of demographic characteristics (age and sex), clinical features, and treatment options in case of AT. Material and Methods: Examination of publications from PubMed and Google Scholar Search according to the following keywords: “acute abdomen”, “vermiform appendix”, “torsion”, “appendectomy” with identification of 40 cases of AT in adults reported during the period 1918-2020. Results: Mean age – 42.03±2.83 years, M:W=1.2:1. The angle of rotation 180°–1800°, the direction is frequently counterclockwise, the point of torsion is usually 1.0 or more centimeters from the base of the appendix. Several etiologies of AT are described: primary causes–15(37.5%) or some pathological conditions, such as mucocele–8(20%), mucinous cystadenoma–7(17.5%), mesoappendiceal lipoma–2(5%), fecalith implantation–2(5%), and others–6(15%). Most patients present with clinical signs suggestive of acute appendicitis, including pain in the right lower quadrant of the abdomen, vomiting, nausea, fever, anorexia. Laboratory tests and paraclinical examinations (abdominal radiography, ultrasonographic examination, computed tomography, nuclear magnetic resonance) are nonspecific, as a result, preoperative diagnosis is difficult. Emergent appendectomy, open (n=32;80%) or laparoscopic (n=8;20%), is the treatment of choice, nonoperative management being contraindicated because of a high risk of necrotic perforation. Conclusions: AT is a rare pathological entity that presents clinically appendicitis-like symptoms; however, it should be taken into consideration when assessing the patient with lower right abdominal pain.