DOI: https://doi.org/10.36347/sasjs.2026.v12i08.003

Pages: 655-657

Appendiceal volvulus is a rare surgical condition that is often indistinguishable from acute appendicitis due to its nonspecific clinical presentation. Primary torsion without underlying appendiceal pathology is particularly uncommon. We report a 52-year-old woman with no significant medical history who presented with sudden-onset right iliac fossa pain and elevated inflammatory markers. Abdominal computed tomography suggested acute appendicitis. Laparoscopic exploration revealed a 360° clockwise torsion of the vermiform appendix with ischemic changes and no underlying pathology, consistent with primary appendiceal volvulus. Laparoscopic appendectomy was performed. Histopathology confirmed acute appendicitis with marked edema and vascular congestion. The postoperative course was uneventful. This case highlights that appendiceal volvulus is a rare intraoperative diagnosis that can closely mimic acute appendicitis, emphasizing the importance of considering this entity in patients with suspected appendicitis