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

Abstract

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.

Morphological variations of the vermiform appendix in Iranian cadavers: a study from developing countries

“…Pelvic position was the most common site in Zambia (43.6%) and in Nigeria [14,16]. In another study in Kenyan population the incidence of appendix position was noted retrocaecal in males and subileal in females [17]. Our findings were similar to African study in Ghana in which retrocaecal position was a predominant site of the appendix [6].…”

“…In a study in Germany, the mean length of the appendix was 6.3 cm in females and 7.5 cm in males [20]. In African studies the appendix length varies from 7.65 cm in the Kenian population to 11.7 cm in Zambian people [14,17,18]. In Senegal, the mean length of appendix was 10.64 cm and its diameter was 67.7 cm [18].…”

“…The most common location of the vermiform appendix was retroileal in Thai population [5], while pelvic was a predominant position in Iranian cadavers [9,10,24], which was inconsistent with our finding. Geographical changes, life style, genetic, race and dietary factors are known to play important roles in determining the position of the appendix [1,2,5,7,9,10,17].…”

Retrouterine Perforated Gangrenous Appendicitis

“…In the conditions of the appendix pelvic position, which is significantly less frequently encountered (20%-22%), the appendix hangs freely on the mesentery and may secondarily cause catarrhal inflammation of the right adnexa (salpingoophoritis) and focal peritonitis, especially if it is elongated. Other very rarely described appendix position is subhepatic, usually conditioned by innate bowel malrotation or appendix repression by pregnant uterus [2][3][4] . Retrouterine pelvic appendix position is not described in any case in the literature.…”

A different view of the sonographic classification of the appendix

“…The appendiceal lumen was evaluated and classified as lumen without content or lumen with gas, faeces, fluid or fecalith. The appendix was classified according to the position of its tip as retrocecal (posterolateral or posterior to the cecum), abdominal (appendix in the abdomen, above anterior iliac crests), mid-pelvic (in the pelvis, proximal to the iliac vessels) and deep pelvic (in the pelvis, distal to the iliac vessels) in several studies [24][25][26][27]. On the other hand, we used the level of iliac vessels as a reference line to define the appendix position in the right iliac fossa (Figure 1).…”