Atresia of the appendix vermiformis: A rare case of developmental abnormality

Abstract

Acute appendicitis, which requires immediate surgical intervention, is an important diagnosis in patients with acute abdomen. However, developmental abnormalities may interfere with the preoperative diagnosis and surgical treatment in some cases. Agenesis and atresia of the cecal vermiform appendix is an extremely rare clinical diagnosis. In addition, preoperative diagnosis may be difficult in some cases. Thus, diagnosis of the congenital absence of the vermiform appendix requires a thorough exploration of the retrocecal and ileocecal regions. A 59-year-old male was admitted from the emergency services with right lower abdominal pain. A celiotomy was performed with the suspicion of acute appendicitis. However, an atresia of the vermiform appendix was observed. The patient's appendix was thus removed. Pathological examination confirmed suppurative appendicitis. This case underlines the importance of the clinical entity for surgeons who may deal with a similar case.

A 25-year-old male with appendicular agenesis: A case report and literature review

“…Before diagnosing agenesis or absent appendix, it is imperative to understand that the vermiform appendix is a vestigial remnant that varies in size from 2 cm to 20 cm and, in very rare cases, the appendicular tip may be found embedded inside the lumen of the caecum, often referred to as intussusception of the vermiform appendix. The appendicular agenesis is presumed to be the result of intrauterine vascular accidents, auto amputations due to fibrous bands and appendicular atresia 5 …”

Absence of the appendix discovered during childhood

“…The cause of an absent appendix is postulated to be secondary to an intrauterine vascular accident, (Hei 2003 ) as is noted in pediatric cases of intestinal atresias (Louw and Barnard 1955 ). This theory may be supported by the occasional findings of a fibrotic string-like structure within the peritoneal cavity in some cases where no appendix is found - referred to as autoamputation of the appendix, (Iuchtman 1993 ) and the even rarer phenomenon of appendiceal atresia (Woywodt et al 1998 ; Yaylak et al 2013 ). In addition, there are reports of jejuno-ileal atresias with associated absence of the appendix (Cserni 2006 ; Yokose 1986 ).…”

Appendicular agenesis: a case report

“…The appendicular agenesis is presumed to be the result of intrauterine vascular accidents, auto amputations due to fibrous bands and appendicular atresia. 5 Arrest of development may occur at any stage and give rise to either absence of cecum and appendix (type 1), blunt conical cecum without appendix (type 2), longitudinal symmetrical cecum with longitudinal muscle bands converging toward its apex, but without appendix (type 3), or asymmetric cecum without appendix (type 4). 6 The present case discussed here was type 3 variety of congenital absence of appendix.…”