RSS-Feed abonnieren

DOI: 10.1055/s-0044-1788261
Computed Tomography Scan Correlation of Position of Appendix with Present Literature
Funding None.
Abstract
Background The appendix exhibits varied anatomical orientations, which significantly influence the diagnosis and treatment of appendicitis. Existing literature predominantly relies on cadaveric studies to delineate common appendix positions, lacking comprehensive computed tomography (CT)-based investigations on a large scale. Thus, our study endeavors to delineate the prevailing position of the appendix on CT scans and ascertain its concordance with existing literature, thereby augmenting our understanding of this anatomical entity. This cross-sectional study was conducted in a tertiary care hospital setting.
Materials and Methods A total of 1,068 patients aged 18 years and older, undergoing abdominal CT scans at the hospital between July 2020 and July 2021, were enrolled in the study, with exclusion criteria applied to conditions that could distort anatomical features. The position of the appendix was meticulously documented for each patient, alongside measurements including diameter, wall thickness, and origin. Data collection utilized a predefined Microsoft Excel sheet. Subsequently, numerical and relative frequencies were computed for appendiceal positions and origins. Additionally, diameter and wall thickness were assessed, and pertinent parameters were derived.
Results The relative frequencies of various potential appendiceal positions observed in our study were as follows: subcecal: 6.6%; paracecal: 1.2%; pelvic: 21.9%; postileal: 32.9%; preileal: 6.7%; retrocecal: 28.5%; subhepatic: 2.2%.
Conclusion In contrast to traditional assumptions, our findings reveal that the most prevalent positions of the appendix are postileal, retrocecal, and pelvic, challenging historical beliefs.
Informed Consent
Informed consent was obtained from all participants and assured that no identification would be revealed.
Consultation Fees and Patents
There are no consultation fees or other forms of remuneration from organizations that may gain or lose financially and patents or patent applications whose value may be affected by the publication of this article.
Ethical Standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The study was approved by the Institutional Ethics Committee.
Publikationsverlauf
Artikel online veröffentlicht:
23. Juli 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Randal Bollinger R, Barbas AS, Bush EL, Lin SS, Parker W. Biofilms in the large bowel suggest an apparent function of the human vermiform appendix. J Theor Biol 2007; 249 (04) 826-831
- 2 Moris D, Paulson EK, Pappas TN. Diagnosis and management of acute appendicitis in adults: a review. JAMA 2021; 326 (22) 2299-2311
- 3 Yu D, Gu C, Zhang S, Yang H, Yao T. Ultrasound features and the diagnostic strategy of subhepatic appendicitis. Ann Transl Med 2020; 8 (17) 1083
- 4 Alzaraa A, Chaudhry S. An unusually long appendix in a child: a case report. Cases J 2009; 2 (01) 7398
- 5 Ting JY, Farley R. Subhepatically located appendicitis due to adhesions: a case report. J Med Case Rep 2008; 2 (01) 339
- 6 Wong CH, Trinh TM, Robbins AN, Rowen SJ, Cohen AJ. Diagnosis of appendicitis: imaging findings in patients with atypical clinical features. AJR Am J Roentgenol 1993; 161 (06) 1199-1203
- 7 Wakeley CP. The position of the vermiform appendix as ascertained by an analysis of 10,000 cases. J Anat 1933; 67 (Pt 2): 277-283
- 8 Richmond B. The appendix. In: Townsend CM, Evers BM, Beauchamp RD, Mattox KL. , Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 1st South Asia Edition. Philadelphia:: Elsevier Saunders,; 2016: 1296
- 9 Prystowsky JB, Pugh CM, Nagle AP. Current problems in surgery. Appendicitis. Curr Probl Surg 2005; 42 (10) 688-742
- 10 Chaurasia BD. Small and large intestine. In, Krishna Garg. BD Chaurasia's Human Anatomy, 8th ed.,. New Delhi,: CBS Publishers and distributors Pvt. Ltd,; 2020. ; volume 2, 316.
- 11 Lunniss PJ. Large intestine. In: Standring S. Grey's Anatomy: The Anatomical Basis Of Clinical Practise. 41st ed.,. Elsevier,; 2016: 1142
- 12 Lee SL, Ku YM, Choi BG, Byun JY. In vivo location of the vermiform appendix in multidetector CT. J Korean Soc Radiol 2014; 70 (04) 283-289
- 13 Willekens I, Peeters E, De Maeseneer M, de Mey J. The normal appendix on CT: does size matter?. PLoS One 2014; 9 (05) e96476
- 14 Oh KJ, Cho JS, Shin KS. et al. Normal appendix in adults: MDCT findings about the location, thickness and the presence or absence of intraluminal gas. J Korean Radiol Soc 2006; 55 (04) 373-379
- 15 Picken G, Ellis H, Dixon AK. The normal vermiform appendix at computed tomography: visualization and anatomical location. Clin Anat 1993; 6 (01) 9-14
- 16 Peletti AB, Baldisserotto M. Optimizing US examination to detect the normal and abnormal appendix in children. Pediatr Radiol 2006; 36 (11) 1171-1176
- 17 Yabunaka K, Katsuda T, Sanada S, Fukutomi T. Sonographic appearance of the normal appendix in adults. J Ultrasound Med 2007; 26 (01) 37-43 , quiz 45–46
- 18 Ahmed I, Asgeirsson KS, Beckingham IJ, Lobo DN. The position of the vermiform appendix at laparoscopy. Surg Radiol Anat 2007; 29 (02) 165-168
- 19 Moneer MM. Avoiding muscle cutting while extending McBurney's incision: a new surgical concept. Surg Today 1998; 28 (02) 235-239
- 20 Chan WT, Cheng NHY, Cheng KC. et al. Does appendix position affect the clinical outcome of acute appendicitis?. Ann Coll Surg Hong Kong 2002; 6: 109-112
- 21 Wise SW, Labuski MR, Kasales CJ. et al. Comparative assessment of CT and sonographic techniques for appendiceal imaging. AJR Am J Roentgenol 2001; 176 (04) 933-941
- 22 Balthazar EJ, Birnbaum BA, Yee J, Megibow AJ, Roshkow J, Gray C. Acute appendicitis: CT and US correlation in 100 patients. Radiology 1994; 190 (01) 31-35