Variability in the Position of the Tip of Appendix: A Cross-sectional Analytical Study in South Indian Population

Abstract

Introduction: The fact remains that there are still some ambiguities in our understanding of the locations of the vermiform appendix. Understanding the changes in the position of the vermiform appendix is significant because, in cases of appendicitis, its varying locations may result in varying symptoms and warning indications that mirror those of other illnesses. Aim: To determine any difference between the surgical and anatomical assessment of the position of the appendix. Materials and Methods: A cross-sectional study was conducted in the Departments of General Surgery and Forensic Medicine, Government Medical College, Thiruvananthapuram, Trivandrum, Kerala, India, from January 2020 to July 2021. The position of the appendix in a total of 224 patients was studied, of which 115 were surgical patients and the rest (109) were autopsy cases. All consecutive patients who met the inclusion criteria undergoing appendicectomy were included in the study. A similar procedure was followed in the autopsy series, with the consent of the nearest relatives. The mean and standard deviation were used to summarise continuous data, whereas absolute numbers and percentages were used to summarise categorical data. The prevalence of the position of the appendix was reported as a percentage. Results: The mean ± standard deviation (SD) age for the whole study group was 37.47 ± 19.30 years, and there were 149 (66.52%) males. The most common position of the appendix in the surgical arm was retrocaecal (n=58, 50.43%), and the most common position in the autopsy arm was pelvic (n=36, 33.0%). Overall, the most common position of the appendix was retrocaecal (n=86, 38.39%). Apart from a very mild correlation between age and length of the appendix, with a Pearson's correlation coefficient of -0.2808, there was no correlation between the dimensions of the appendix and anthropometric parameters. Conclusion: The most common position of the appendix is found to be retrocaecal, followed by pelvic and subcaecal. Also, considering the various factors that may influence the position of the appendix, it is difficult to state one position as the most common one.

Keywords

• appendicitis
• appendicectomy
• autopsy
• retrocaecal