Anatomical Variations of Vermiform Appendix on Plain MDCT and Its Association with Acute Appendicitis in Adult Urban Population of Karachi, A Tertiary Care Hospital Experience
DOI:
https://doi.org/10.51985/JBUMDC2021118Keywords:
Anatomical variation, Appendicitis, Multidetector computed tomography, Vermiform appendixAbstract
Objective: To evaluate the anatomical positions of vermiform appendix and its association with acute appendicitis on
Multidetector computed tomography (MDCT).
Study design and setting: A cross sectional study based on hospital database was carried out in Department of Anatomy
in collaboration with Department of Radiology, Liaquat National Hospital.
Methodology: A total of three hundred and six 306 adult urban patients CT axial images were evaluated retrospectively
over period of 6 months from March 2021 to August 2021 who had abdominal MDCT scan for acute abdomen after getting
approval from ethical committee to find out anatomical variations of position of vermiform appendix in a tertiary care
hospital among adult urban Karachi population and its association with appendicitis. Data was analyzed using SPSS version
25. All categorical variables were summarized as frequencies and percentages.
Result: In present study 159(52%) were males and 147(48%) were females with mean age of 32.97 years. The subcecal
anatomical position of vermiform appendix on MDCT was most common n=85(27.8%), followed by postileal n=78(25.5%),
pelvic n=61(19.9%), postcecal n= 36(11.8%), preileal n=29(9.5%), ectopic n=17(5.6%). The association between appendicitis
with anatomical position of vermiform appendix and age was analyzed by chi- square and was statistically significant (p
=0.05). There was no significant association between position of vermiform appendix on MDCT and gender.
Conclusion: The subcecal position of vermiform appendix is most common on MDCT and the postileal position was more
frequent in the inflamed group of vermiform appendix
References
Iqbal J, Sayani R, Tahir M, Mustahsan SM. Diagnostic
efficiency of multidetector computed tomography in the
evaluation of clinically equivocal cases of acute appendicitis
with surgical correlation. Cureus. 2018 ;10(3). DOI: 10.7759/
cureus.2249
Vidya CS, Kuberappa V. Anatomical variations of caecum
and appendix: A cadveric study in Mysore based population.
Indian Journal of Clinical Anatomy and Physiology. 2016
;3(3):265-8. DOI: 10.5958/2394-2126.2016.00059.1
Abegaz BA, Woldeyes DH, Awoke DG, Kiros MD. A study
of the variations of positions of vermiform appendix in
appendicitis patients in Northern Ethiopia. Journal of
Experimental and Clinical Anatomy. 2016 ;15(2):73 DOI:
4103/1596-2393.200915
Lee SL, Ku YM, Choi BG, Byun JY. In vivo location of the
vermiform appendix in multidetector CT. Journal of the
Korean Society of Radiology. 2014 ;70(4):283-9.DOI:
https://doi.org/10.3348/jksr.2014.70.4.283
Jagdish P, Ashoka RK. Morphometry of Vermiform Appendix:
A Human Cadaveric study. Journal of Dental and Medical
Sciences. 2018;17(8):72-6. DOI: 10.9790/0853-1708137276
Kuzan BN, Kuzan TY, Ergelen R. A new parameter in the
diagnosis of acute appendicitis: Ileocolic artery and vein
diameter measurements. Annals of Medical Research.
;26(9):2082-7. DOI: 10.5455/annalsmedres.2019.06.308
;26(9):2082-7
Pattern and positions of vermiform appendix in people of
Bannu district. Gomal Journal of Medical Sciences. 2012 Jul
;10(1). Ghorbani A, Forouzesh M, Kazemifar AM. Variation
in anatomical position of vermiform appendix among iranian
population: an old issue which has not lost its importance.
Anatomy research international. 2014;2014 http://dx.doi
.org/10.1155/2014/313575
Afzal M, Al-Yahri O, Musthafa S, Ali SM, Ghali MS. RetroPsoas Appendix: A Rare Atypical Position of the Appendix
Tip Radiological Images and Review of Literature. European
Journal of Applied Sciences–Vol. 2021 ;9(6). DOI:10.14738
/aivp.96.11497.
Lamture YR, Salunke B. Anatomical variations related to
position of appendix. Journal of Evolution of Medical and
Dental Sciences. 2018 ;7(46):5830-4.
Ashindoitiang JA, Ibrahim NA. Anatomical variations of
appendix in patients with acute appendicitis among two major
tribes in Lagos Nigeria. International Journal of Medicine
and Medical Sciences. 2012 Mar 26;2(3):1-6. https://www.
internationalscholarsjournals.com/articles/anatomicalvariations-of-appendix-in-patients-with-acute-appendicitisamong-two-major-tribes-in-lagos-nigeria.pdf
Ahmad MA, Ali MT, Zarkoon N, Khan NM. Variations in
the Position and Length of the Vermiform Appendix in
Pakistani Population. Pak J Med Health Sci. 2017 Jan
;11(1):356-61. https://www.pjmhsonline. com/2017/
jan_march/pdf/356.pdf
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. International Scholarly Research
Notices. 2014;2014. http://dx.doi.org/10.1155/2014/871048
Wael H, Saher E. Preoperative Multidetector Computed
Tomography (MDCT) Using Contrast Media for Suspected
Acute Appendicitis in Adults: Value and Accuracy. The
Medical Journal of Cairo University. 2019 ;87:2523-30. DOI:
21608/mjcu.2019.54862 Inclusion criteris
Zacharzewska-Gondek A, Szczurowska A, Guziñski M,
S¹siadek M, Bladowska J. A pictorial essay of the most atypical
variants of the vermiform appendix position in computed
tomography with their possible clinical implications. Polish
journal of radiology. 2019;84:e1. doi: 10.5114/pjr.2018.81158
Iqbal T, Amanullah A, Nawaz R. Pattern and positions of
vermiform appendix in people of Bannu district. Gomal
Journal of Medical Sciences. 2012 ;10(1)
Ali U, Noor A, Jan WA, Islam M, Khan AS, Khan M. The
Position of appendix and its related morbidity. Journal of
Bacha Khan Medical College. 2017 ;1(1):5
Lee SL, Ku YM, Choi BG, Byun JY. In vivo location of the
vermiform appendix in multidetector CT. Journal of the
Korean Society of Radiology. 2014 ;70(4):283-9.
Chaisiwamongko K, Chantaupalee T, Techataweewan N,
Toomsan Y, Aranateerakul T, Teepsawang S, Iamsaard S,
Srikulwong T. Position Variation of Vermiform Appendix in
Northeast Thai Cadavers. Srinagarind Medical Journal.
;25(3):250-5.
Mohammadi S, Hedjazi A, Sajjadian M, Rahmani M,
Mohammadi M, Moghadam MD. Morphological variations
of the vermiform appendix in Iranian cadavers: a study from
developing countries. Folia morphologica. 2017;76(4):695-
DOI: 10.5603/FM.a2017.0032
MooreKL,Dalley AF. The pelvis and perineum.In Moore KL,
Dalley AF. Clinically oriented Anatomy, 8th ed.
Philadelphia:Lippincott Williams&Wilkins,2018:1294-1304.
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. International Scholarly Research
Notices. 2014;2014. http://dx.doi.org/10.1155/2014/871048
Lamture YR, Salunke B. Anatomical variations related to
position of appendix. Journal of Evolution of Medical and
Dental Sciences. 2018;7(46):5830-4.
Ashindoitiang JA, Ibrahim NA. Anatomical variations of
appendix in patients with acute appendicitis among two major
tribes in Lagos Nigeria. International Journal of Medicine
and Medical Sciences. 2012;2(3):1-6.
Evrimler S, Okumuser I, Unal N. Computed tomography (CT)
findings of a diagnostic dilemma: atypically located acute
appendicitis. Polish journal of radiology. 2016;81:583. doi:
12659/PJR.898880.
Ahmad MA, Ali MT, Zarkoon N, Khan NM. Variations in
the Position and Length of the Vermiform Appendix in
Pakistani Population. Pak J Med Health Sci. 2017;11(1):356-
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Lubna Faisal, Rizwan Ajmal, Fatima Rehman, Zia ul Islam, Sadia Abdul Qayyum, Saima Athar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0 
