Congenital abnormalities and anatomical variations of the vermiform appendix and mesoappendix

Abstract

Aim The purpose of this review was to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies. Methods The search was carried out in the following databases: PubMed, Science Direct, and SciELO. Results Thirty-seven studies were included in this review. Among the abnormalities of the vermiform appendix identified are agenesis and duplicity, and anatomical variations were related to length and positioning. Appendicular duplicity was a more frequent abnormality, mainly Type B2, associated with acute appendicitis, followed by agenesis, Type III. The first case of agenesis associated with acute appendicitis and volvulus-type duplicity of the appendix was identified. The most frequent position was retrocecal in adults and pelvic in children. In the mesoappendix, anatomical variations in its positioning, shape, absence, and length were identified. Conclusion This review sought to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies, contributing to aid in clinical diagnosis and surgical interventions in patients with suspected acute appendicitis.

Appendiceal Agenesis: A Very Rare Intraoperative Diagnosis – A Case Report

“… 4 , 15 Intestinal malformations, dextrocardia, hexadactylism and congenital cataract are also mentioned as associated conditions, which are absent in our patient. 4 , 5 , 8…”

“…The diagnosis can be challenging if the presentation is atypical and this may result in treatment delay. 4 , 11 , 12 Alvarado score is the most widely used scoring system in the clinical diagnosis of this condition. A systematic review done by Ohle et al reported Alvarado score as an accurate diagnostic “rule out” score at a cut point 5 for all patients.…”

“…The diagnosis can be challenging if the presentation is atypical and this may result in treatment delay. 4 , 11 , 12 …”

“…2 It is a very rare congenital anomaly which occur in 0.001% of laparotomies done for the assumption of acute appendicitis. 1,[3][4][5][6][7][8][9] Diagnosis of this rare condition is made intraoperatively after a thorough laparotomic or laparoscopic exploration. 8,10 Acute appendicitis is the commonest reason for emergency surgery and diagnosis is predominately based on clinical examination.…”

Acute suppurative inflammation in dual appendix

“…In the previous case reports the patient had undergone appendicectomy on two occasions which can give rise to significant morbidity and mortality [3]. In selected cases, the caecum should be carefully examined for appendices anomalies [4]. To the best of our knowledge, this is the 1st case reported from Sri Lanka.…”