Article

The position of the vermiform appendix at laparoscopy. Surg Radiol Anat

Division of Gastrointestinal Surgery, Wolfson Digestive Diseases Centre, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, NG7 2UH, UK.
Surgical and Radiologic Anatomy (Impact Factor: 1.05). 04/2007; 29(2):165-8. DOI: 10.1007/s00276-007-0182-8
Source: PubMed

ABSTRACT

The vermiform appendix has no constant position and the data on the variations in its position are limited. The aim of this study was to determine the frequency of the various positions of the appendix at laparoscopy.
Patients undergoing emergency or elective laparoscopy at a university teaching hospital between April and September 2004 were studied prospectively. The positions of the appendix and the caecum were determined after insertion of the laparoscope, prior to any other procedure and the relative frequencies calculated.
A total of 303 (102 males and 201 females) patients with a median age of 52 years (range 18-93 years) were studied. An emergency appendicectomy was performed in 67 patients, 49 had a diagnostic laparoscopy, 179 underwent a laparoscopic cholecystectomy and eight had other procedures. The caecum was at McBurney's point in 245 (80.9%) patients, pelvic in 45 (14.9%) and high lying in 13 (4.3%). The appendix was pelvic in 155 (51.2%) patients, pre-ileal in 9 (3.0%), para-caecal in 11 (3.6%), post-ileal in 67 (22.1%) and retrocaecal in 61 (20.1%) patients.
Contrary to the common belief the appendix is more often found in the pelvic rather than the retrocaecal position. There is also considerable variation in the position of the caecum.

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    • "It seems that many factors, including race, are involved in determining the position of the appendix. Our findings were similar to studies of Denjali´c et al. [7] and Golalipour et al., conducted in Iran [15], who have evaluated the patients in surgery ward, study of Yabunaka et al. [16] who have evaluated the size of appendix by sonography, and study of Ahmed et al. [17] who have estimated the appendix size during therapeutic laparotomy. The most common position of appendix has been pelvic position in all of these studies. "
    Dataset: 313575 (1)

    Full-text · Dataset · Sep 2014
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    • "It seems that many factors, including race, are involved in determining the position of the appendix. Our findings were similar to studies of Denjali´c et al. [7] and Golalipour et al., conducted in Iran [15], who have evaluated the patients in surgery ward, study of Yabunaka et al. [16] who have evaluated the size of appendix by sonography, and study of Ahmed et al. [17] who have estimated the appendix size during therapeutic laparotomy. The most common position of appendix has been pelvic position in all of these studies. "
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    ABSTRACT: Vermiform appendix has diverse anatomical positions, lengths, and conditions of mesoappendix. Knowing the exact anatomical position of vermiform appendix is important in view of surgeons for on-time diagnosis and management of acute appendicitis. The aim of present study is determination of these characteristics of vermiform appendix among Iranian population. The present study was conducted on 200 bodies, selected from the dead bodies that had been referred to local bureau of legal medicine, Zenjan province, Iran, for medicolegal autopsy since 21 Mar 2010 to 21 Mar 2011. According to the results, the anatomical positions of the appendix were pelvic, subcecal, retroileal, retrocecal, ectopic, and preileal in 55.8%, 19%, 12.5%, 7%, 4.2%, and 1.5% of the bodies, respectively. The mean length of vermiform appendix was 91.2 mm and 80.3 mm in men and women, respectively. Mesoappendix was complete in 79.5% of the bodies. No association was found between sex and anatomical position of vermiform appendix. Anterior anatomical position was the most common position for vermiform appendix. It is inconsistent with most related reports from western countries. It might be possible that some factors, such as race, geographical changes, and dietary habits, play roles in determining the position of vermiform appendix.
    Full-text · Article · Sep 2014
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    • "The position of the appendix can also lead to difficulty in its visualisation. A retrocaecal appendix can occur in 20.1–65 % of patients [34, 35] and will be difficult to visualise on US [6, 24, 30]. The appendix may be also anatomically abnormally positioned, such as abnormalities of situs, when the caecum is mobile or subhepatic, or in cases of congenital malrotation [36–38]. "
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    ABSTRACT: Acute appendicitis is a common surgical emergency in the paediatric population. Computed tomography (CT) has been shown to have high accuracy and low operator dependence in the diagnosis of appendicitis. However, with increased concerns regarding CT usage in children, ultrasound (US) is the imaging modality of choice in patients where appendicitis is suspected. This review describes and illustrates the step-wise graded-compression technique for the visualisation of the appendix, the normal and pathological appearances of the appendix, as well as the imaging characteristics of the common differentials. • A step-wise technique improves the chances of visualisation of the appendix. • There are often several causes for the non-visualisation of the appendix in children. • A pathological appendix has characteristic US signs, with several secondary features also identified. • There are multiple common differentials to consider in the paediatric patient.
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