Anatomical variations of caecal appendix on tomography, a retrospective study. Variaciones anatómicas del apéndice cecal en tomografía, un estudio retrospectivo.

Resumen

Introduction: the most common surgical cause of abdominal pain is appendicitis; its diagnosis is affected by anatomical variations of the vermiform appendix, because this is the most variable abdominal organ in terms of position and organ relations. Objective: to determine the characteristics of the normal appendix in computed tomography scans, including length, diameter, wall thickness, and the location of the base and the appendicular tip. Methods: abdominal computed tomography scans with UroCT scan protocol images were studied to measure length, width, and diameter of the appendix, and to identify the locations of its base and tip. The appendicular tip location was categorized as anterior or posterior and subdivided into: pelvic, retrocaecal/retrocolic, postileal, paracolic, subcaecal, subhepatic or midline. The appendicular base location was defined in three planes in relation to the ileocaecal valve: anterior-posterior, medial-lateral, or superior-inferior. Results: were included the abdominal tomography images of 83 patients in which general characteristics of the appendix were determined: a mean length of 78 mm (SD = ±23.41) and a mean diameter of 6.55 mm (SD =± 1.77) were observed. The bases were more frequently located inferior posterior, lateral and medial, to the ileocaecal valve, and the tips were more frequently located in the pelvic cavity, followed by the retrocaecal and paracaecal location. Conclusions: the locations of the base of the appendix were correlated with overall reports. There was no correlation between the tip location and the length of the appendix, this means that, even if the appendix is long, it is not associated with a tip location further from the ileocaecal valve.