Variables in right iliac fossa anatomy and their relevance to appendicectomy: Improving knowledge and practices

Hegde, D K; Hegde, Sachin Dev

doi:10.1002/ca.20587

Cited by 5 publications

(3 citation statements)

References 9 publications

(5 reference statements)

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“…However, taking into consideration that the distance between the base of the VA and ileocecal valve is relatively constant, prior localization of the latter may facilitate proper identification of the appendix stump and help avoid an unwanted conversion. Hedge et al claimed that the position of the appendiceal base in relation to the ileocecal junction was even more important than the position of the appendiceal body itself, due to the high mobility of both the cecum and the VA to which access could be gained regardless of their primary position (Hegde and Hegde 2008). Nevertheless, literature on this subject is limited.…”

Section: Discussionmentioning

confidence: 99%

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

et al. 2019

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Determining the true and indisputable data regarding the vermiform appendix (VA) morphology is of a great clinical interest. The aim of this study was to provide the best evidence‐based anatomical overview of the variations in location and size of VA using a systematic and meta‐analytical approach. A systematic review with meta‐analysis was performed of studies reporting variants of the location and morphometric data regarding the VA. The MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science databases were thoroughly searched throughout June 2018. The reported locations of the body of the VA were re‐classified into a new, standardized classification system divided into nine categories. The AQUA tool was used to assess the quality of included studies. The research was conducted following PRISMA guidelines and registered at PROPSERO database. Our meta‐analysis included 242 studies (n = 114,080). Overall, the VA was most commonly found in the retrocecal location (32.1%, 95%CI: 29.2–35.1), followed by the pelvic (28.5%, 95%CI: 26.7–30.4) and ileal (14.5%, 95%CI: 11.8–17.7) locations. Subjects without known appendiceal pathologies had significantly smaller VA outer diameters (5.84 mm, 95%CI: 5.68–5.99) than patients diagnosed with acute appendicitis (10.64 mm, 95%CI: 10.14–11.15). The overall pooled mean length of the VA was 80.29 mm (95%CI: 76.68–83.89). Significant differences were found in size of the VA between imaging modalities. The results obtained from this evidence‐based anatomy study will improve the clinical understanding of the VA anatomy, which in turn will have major implications for clinical practice. Clin. Anat. 32:85–98, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

et al. 2019

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“…A study by D. Hegde and S. D. Hegde (2008), using 100 patients in whom a radio-opaque marker was placed during appendectomy, found a more superomedial location of the appendix in 75% of cases [ 21 ]. The study by Naraynsingh et al also found 67% prevalence of appendices that were cephalic to spinoumbilical line [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Variations in the Position and Length of the Vermiform Appendix in a Black Kenyan Population

et al. 2014

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Background. Topography of the appendix influences its mobility, degree of mobilization of the cecum, and need for additional muscle splitting during appendectomy. Although appendectomy is a common surgical procedure, there is a paucity of data on its topography in black Africans. Methods. The position and length of the appendix and relation of the appendicular base with spinoumbilical line were determined in 48 cadavers obtained from the Department of Human Anatomy, University of Nairobi, Kenya. Results. The commonest appendicular types in males were retrocecal 10 (27%) while in females was subileal 4 (36.4%). The average length of the appendix was 76.5 ± 23.6 mm. The base of the appendix was located along, below, and above the spinoumbilical line in 25 (52.1%), 9 (18.8%), and 14 (29.2%) cases, respectively. Conclusion. The topography of appendix in Kenyans shows variations from other populations. Knowledge of these variations is important during appendicectomy.

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“…Appendix muscle bands (AMB) are rarely mentioned although the initial descriptions date the pre‐50ies (Downs, 1942; Gerster, 1915; Oelhafen et al, 2012). Of note would be the persistence of difficulties in appendix surgery, as suggested by several, some recent, publications (Awari et al, 1995; Hedge and Hedge, 2008; Kacprzyk et al, 2020). Appendix bands, considered lesions of uncertain etiology (possibly congenital) may be detected in association with possibly life‐threatening complications such as appendix torsion, intestinal obstruction, and acute appendicitis and abdomen (Demir et al, 2017; Singal et al, 2017).…”

Section: Introductionmentioning

confidence: 94%

Appendix muscle bands, a forgotten entity

Handra‐Luca

2020

Clinical Anatomy

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Introduction Appendix muscle bands (AMB) develop from the appendix muscle layer into the mesoappendix. There are few recent publications on this forgotten entity. The objectives of this study were to assess the morphological features of AMB as detected at microscopy examination of appendectomy specimens. Methods Sixty‐six cases of AMB as detected on appendectomy specimens were assessed for microscopy features on routine hematoxilin and eosin stained tissue slides. The morphological features were analyzed with regard to the main clinico‐pathological parameters. Results AMBs were multiple in 35 cases. Most AMBs were located between the tip and cecal limit, 7 at the tip, and 1 at the cecal limit of the appendectomy specimen. Associated appendix lesions were: acute appendicitis, neuroma, mesoappendix cyst, muscle hiatus, and diverticulae (60,6,2,45, and 1, respectively). In 24 appendices, the AMB developed from the perihiatus muscle. Two microscopy types of AMBs were detected: muscle‐AMB and mesoappendix‐AMB. Conclusion AMB may be detected incidentally at microscopy of appendectomy specimens. Acute appendicitis was associated in most cases, independently on the microscopy type of AMB. Appendix abnormalities as neuroma, mesoappendix cyst, muscle hiatus, and diverticulae can be associated to AMBs.

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Variables in right iliac fossa anatomy and their relevance to appendicectomy: Improving knowledge and practices

Cited by 5 publications

References 9 publications

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

Variations in the Position and Length of the Vermiform Appendix in a Black Kenyan Population

Appendix muscle bands, a forgotten entity

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