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文献考察:虫垂捻転（torsion of vermiform appendix）
１） Pediatr Pathol Lab Med. 1996 Jul-Aug;16(4):655-61.
Primary acute torsion of the vermiform appendix.
Val-Bernal JF, Gonzalez-Vela C, Garijo MF.
A case of primary acute appendiceal torsion in a 6-year-old boy with symptoms suggestive of acute appendicitis is presented. The appendix was abnormally long, measuring 13.5 cm in length. Although appendicitis is the most common intra-abdominal surgical emergency, there are few descriptions of primary acute appendiceal torsion, a rare cause of an acute abdomen. A review of the English language literature disclosed 19 reports, including the present, with 11 pediatric cases. The site of torsion occurs most frequently 1 cm or more from the appendiceal base. Rotation varies from 270 degrees to 1080 degrees with a mean of 580 degrees. The direction of the rotation is more frequently anticlockwise. Appendix is most commonly described as lying free or pelvic. In children the mean age is 9.1 years, the range 3-16 years, and the male-to-female ratio 4.5:1.PMID: 9025862
２）腹腔鏡下虫垂切除術を施行した虫垂捻転症の1例
Author：山内希美(木沢記念病院), 山内一, 田辺博
Source：外科(0016-593X)61巻13号 Page1725-1727(1999.12)
要旨：1997年までに43例の報告がある．男性に多く，20歳前後に最も多い．急性虫垂炎との鑑別は困難である．捻転の角度は100度〜900度の報告があるが180度〜360度が多く，方向は時計方向と反時計方向がほぼ同数．捻転部位は根部15例，中部11例．発生機転は，１）盲腸または虫垂に主因がある場合（虫垂過長，虫垂内異物，虫垂炎，虫垂腫瘍，盲腸の刺激など），２）虫垂間膜に主因がある場合（虫垂間膜過長，虫垂間膜の炎症，虫垂間膜の萎縮瘢痕，総腸間膜症，腸間膜脂肪組織の多寡など）がいわれるが定説はない．
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