Variations in the Position of the Vermiform Appendix in Patients undergoing Open Appendectomy at Hayatabad Medical Complex, Peshawar

Falak Naz; Sumaira Javed; Fatma Afridi; Muhammad Shahsawar Khan Afridi; Habiba Ahmad; Ayesha Anwar Badshah

doi:10.70749/ijbr.v4i5.3221

Authors

Falak Naz Department of Anatomy, Khyber Medical College, Peshawar, Pakistan
Sumaira Javed Department of Anatomy, Ayub Medical College, Abbottabad, Pakistan
Fatma Afridi Khyber Medical College, Peshawar, Pakistan
Muhammad Shahsawar Khan Afridi Ayub Medical College, Abbottabad, Pakistan
Habiba Ahmad Peshawar Medical College, Peshawar, Pakistan
Ayesha Anwar Badshah Khyber Medical College, Peshawar, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v4i5.3221

Keywords:

Vermiform appendix; retrocaecal; Paracolic; Position; Anatomy; Subcaecal

Abstract

Objective: Due to the diverse anatomical positions of vermiform appendix it is important to know its variations in view of surgeons for prompt diagnosis and management of acute appendicitis. The aim of this study was to contribute to the knowledge of vermiform appendix anatomy and the variation in its position in people belonging to our part of the world mainly Khyber Pakhtunkhwa. Materials and Method: This study was of one year duration i.e from February, 2024 to February 2025, and carried out at Hayatabad Medical Complex, Peshawar. A total of 200 cases both male and female of all ages were included in the study who underwent appendectomy. After identification of the vermiform appendix its position was noted and recorded. Results: Retrocecal position was most commonly seen in 90 cases (45 %), followed by pelvic in 64 case (32%), Post- ileal in 16 cases (8%), Pre-ileal in 10 cases (5%), Subcaecal in 10 cases (5%) Right Paracolic in 6 cases (3%) and Retrocolic in 4 cases (2%). It is important to know about the variation in the position of vermiform appendix during appendectomies. Conclusion: The finding of the present study highlight the fact that variation in the position of vermiform appendix occur in high percentage of cases.

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References

1. Delić J, Savković A, Isaković E. Variations in the position and point of origin of the vermiform appendix. Medicinski arhiv. 2002;56(1):5-8.

2. Ahmed I, Asgeirsson KS, Beckingham IJ, Lobo DN. The position of the vermiform appendix at laparoscopy. Surgical and Radiologic Anatomy. 2007;29(2):165-8.

https://doi.org/10.1007/s00276-007-0182-8

3. Paul UK, Naushaba H, Alam MJ, Begum T, Rahman A, Akhter J. Length of vermiform appendix: a postmortem study. Bangladesh Journal of Anatomy. 2011;9(1):10-2.

https://doi.org/10.3329/bja.v9i1.8140

4. Wakeley CP. The position of the vermiform appendix as ascertained by an analysis of 10,000 cases. Journal of anatomy. 1933;67(Pt 2):277.

5. Pittman-Waller VA, Myers JG, Stewart RM, Dent DL. Appendicitis: why so complicated? Analysis of 5755 consecutive appendectomies. The American surgeon. 2000;66(6):548.

https://doi.org/10.1177/000313480006600605

6. Ball WR, Privitera A. Subhepatic appendicitis: a diagnostic dilemma. BMJ case reports. 2013;2013.

https://doi.org/10.1136/bcr-2013-009454

7. Ting JY, Farley R. Subhepatically located appendicitis due to adhesions: a case report. Journal of medical case reports. 2008;2(1):339.

https://doi.org/10.1186/1752-1947-2-339

8. Alzaraa A, Chaudhry S. An unusually long appendix in a child: a case report. Cases journal. 2009;2(1):7398.

https://doi.org/10.4076/1757-1626-2-7398

9. Malik RA, Mir SH, Feroz I, Yasir M, Baba KM, Alam K. An unusual case report-longest appendix in India (20.5 cm). Oncology, Gastroenterology and Hepatology Reports. 2013;2(1).

https://doi.org/10.4103/2348-3113.133581

10. Sharma SB, Gupta V. Acute appendicitis presenting as acute hemiscrotum in a boy. Indian journal of gastroenterology: official journal of the Indian Society of Gastroenterology. 2004;23(4):150-.

11. Turkoglu H, Onur MR, Poyraz AK, Kocakoc E. Evaluation of normal appendix vermiformis in adults with multidetector computed tomography. Clinical imaging. 2012;36(6):758-62.

https://doi.org/10.1016/j.clinimag.2012.01.028

12. Mwachaka P, El-busaidy H, Sinkeet S, Ogeng’o J. Variations in the position and length of the vermiform appendix in a black kenyan population. ISRN anatomy. 2014;2014.

https://doi.org/10.1155/2014/871048

13. Paul UK, Naushaba H, Begum T, Alam J, Alim AJ, Akther J. Position of vermiform appendix: a postmortem study. Bangladesh J Anat. 2009;7(1):34-6.

https://doi.org/10.3329/bja.v7i1.3015

14. Patel S, Jumba G, Akmal S. Laparoscopic appendicectomy at the Aga Khan Hospital, Nairobi. East African medical journal. 2003;80(9):447-51.

https://doi.org/10.4314/eamj.v80i9.8740

15. O'Connor CE, Reed WP. In vivo location of the human vermiform appendix. Clinical Anatomy: The Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. 1994;7(3):139-42.

16. Tofighi H, Taghadosi-Nejad F, Abbaspour A, Behnoush B, Salimi A, Dabiran S, et al. The anatomical position of appendix in Iranian cadavers. International journal of medical toxicology and forensic medicine. 2013;3(4):126-30.

17. Kakande I, Nehra M. Appendicectomy in Consolata Hospital, Nyeri: analysis of operative and histological findings. East African medical journal. 1990;67(8):573-7.

18. Iqbal T, Rabnawaz AI, Tahir F, Zaman S. A Meta-Analysis of History and Functions of Vermiform Appendix. Pak J Surg. 2011;27(4):316-20.

19. Salwe NA, Kulkarni P, Sinha R. Study of morphological variations of vermiform appendix and caecum in cadavers of western Maharashtra region. International Journal of Advanced Physiology and Allied Sciences. 2014;1(1):pp. 31-41.

20. Ajmani M, Ajmani K. The position, length and arterial supply of vermiform appendix. Anatomischer anzeiger. 1983;153(4):369-74.

21. Ojeifo J, Ejiwunmi A, Iklaki J. The position of the vermiform appendix in Nigerians with a review of the literature. West African journal of medicine. 1989;8(3):198-204.

22. Clegg-Lamptey J, Armah H, Naaeder S, Adu-Aryee N. Position and susceptibility to inflammation of vermiform appendix in Accra, Ghana. East African medical journal. 2006;83(12):670-8.

https://doi.org/10.4314/eamj.v83i12.9498

23. Golalipour M, Arya B, Azarhoosh R, Jahanshahi M. Anatomical variations of vermiform appendix in south-east Caspian sea (Gorgan-Iran). J Anat Soc India. 2003;52(2):141-3.

24. Yabunaka K, Katsuda T, Sanada S, Fukutomi T. Sonographic appearance of the normal appendix in adults. Journal of ultrasound in medicine. 2007;26(1):37-43.

https://doi.org/10.7863/jum.2007.26.1.37

25. Hegde D, Hegde SD. Variables in right iliac fossa anatomy and their relevance to appendicectomy: improving knowledge and practices. Clinical Anatomy: The Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. 2008;21(2):165-70.

https://doi.org/10.1002/ca.20587

26. Naraynsingh V, Ramdass M, Singh J, Singh-Rampaul R, Maharaj D. McBurney's point: are we missing it? Surgical and Radiologic Anatomy. 2002;24(6):363-5.

https://doi.org/10.1007/s00276-002-0069-7

27. Ramsden W, Mannion R, Simpkins K. Is the appendix where you think it is—and if not does it matter? Clinical radiology. 1993;47(2):100-3.

https://doi.org/10.1016/s0009-9260(05)81181-x

28. Bakheit M, Warille A. Anomalies of the vermiform appendix and prevalence of acute appendicitis in Khartoum. East African medical journal. 1999;76(6):338-40.

29. Harsha W. Retrocecal appendix: its diagnosis and surgical approach. Surg Gynecol Obstet. 1942;74:180-1.

30. Herscu G, Kong A, Russell D, Tran C-L, Varela JE, Cohen A, et al. Retrocecal appendix location and perforation at presentation. The American surgeon. 2006;72(10):890-3.

https://doi.org/10.1177/000313480607201010

31. Williams NS, Bulstrode CJ, O'Connell PR, Bailey H, Love R. Bailey and Love's short practice of surgery. London: Hodder Arnold; 2008.

32. Searle AR, Ismail KA, MacGregor D, Hutson JM. Changes in the length and diameter of the normal appendix throughout childhood. Journal of pediatric surgery. 2013;48(7):1535-9.

https://doi.org/10.1016/j.jpedsurg.2013.02.035

33. Kjossev K, Losanoff J. Duplicated vermiform appendix. British journal of surgery. 1996;83(9):1259-

https://doi.org/10.1046/j.1365-2168.1996.02343.x