A 40-year-old man presented with sudden right lower quadrant abdominal pain, without fever. Biological explorations showed white blood cells = 11 000g/L and CRP = 3ng/mL. An abdominal CT-scan was therefore required to detect an appendicitis. Coronal (Fig. 1A) and sagittal (Fig. 1B) view images demonstrated a thin appendix (arrow) without fluid content, a fat stranding only on the upper side of the appendix (arrowhead). There was no appendicolith, no abscess and no periappendiceal fluid collection. However, the radiologist concluded that acute appendicitis was onset. Furthermore, despite the absence of clear CT signs of acute appendicitis and abdominal defense on clinical examination, the surgeon chose to operate on the patient. The operative findings were as follows (Fig. 1C): healthy appendix (arrow), torsion and necrosis of a fatty appendix on the upper border of the vermiform appendix at the junction of the middle and the distal third of the appendix (arrowhead).
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