Appendix Research Papers - Academia.edu (original) (raw)

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... more

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.

The aetiological importance of stressful life events and psychological characteristics was assessed amongst 280 appendicectomy patients of whom 80% were classified with 'acutely inflamed' (organic) appendicitis and 20%... more

The aetiological importance of stressful life events and psychological characteristics was assessed amongst 280 appendicectomy patients of whom 80% were classified with 'acutely inflamed' (organic) appendicitis and 20% with 'non-inflamed' (non-organic) appendicitis. Patients were compared with a community comparison group. Specific characteristics of life stressors, namely severe goal frustration for organic patients and severe threat for non-organic patients, were the best predictors of patient outcome. Whilst psychological characteristics were not useful in discriminating between patients, depression in particular, was clearly associated with both conditions, with 38% of non-organic and 28% of organic patients with depression scores in the clinical range. As the patient's clinical depression status failed to modify the effect of the life stress predictors, it was concluded that life stress played an important role in the development of the patients GI symptoms, irrespective of their clinical depression status.

Endometriosis affects 3 to 10 percent of women of reproductive age. Most of the time it involves the pelvis; however, sites of endometriosis have been reported almost anywhere in the body. Appendiceal and primary umbilical endometriosis... more

Endometriosis affects 3 to 10 percent of women of reproductive age. Most of the time it involves the pelvis; however, sites of endometriosis have been reported almost anywhere in the body. Appendiceal and primary umbilical endometriosis are considered rare loci, making accurate diagnosis elusive. Here we present the case of a 46-year-old woman with concurrent appendiceal and umbilical endometriosis. A 46-year-old Greek woman presented with a large mass in the lower abdomen adhering to the surrounding organs. She reported recurrent lower abdominal and pelvic pain and the presence of a dark-blue hard nodule at the umbilicus. She had no previous medical, surgical or gynecological history. Her physical examination and laboratory test results were without any significant findings. The laparotomy revealed a fibromatose uterus adhering to the rectum and a urinary cyst and a palpable mass in the vermiform appendix. A hysterectomy and an appendectomy were performed. The umbilical mass was al...

Abstract: The size, shape, position and arterial supply of the caecum and appendix vary in different individuals of different sex and age. Therefore, a thorough knowledge of normal and abnormal anatomy, arterial supply of the caecum,... more

Abstract: The size, shape, position and arterial supply of the caecum and appendix vary in different individuals of
different sex and age. Therefore, a thorough knowledge of normal and abnormal anatomy, arterial supply of the caecum,
appendix and ileocaecal junction is very important to surgeon performing abdominal operations in adults, children and
infants. The clinical features of acute appendicitis vary according to its position, the age of the patient and obese
individuals. Ischemia (or) Thrombosis of appendicular artery leads to gangrene of the appendix. The present work
consists of the study of the caecum and vermiform appendix in human fetuses and adults. The total numbers of
specimens studied are 50, out of which 25 are adult cadavers. The situation of caecum in 24 adult specimens is in the
righty iliac fossa and 1 specimen is in sub hepatic in position. Out of 25 adults specimens 22 are normal adult type
(ampullary type) (88%) and 2 specimens 8% are exaggerated type and only one specimen 4% is conical type. The shape
of caecum in adults is asymmetrical type (adult) 100%.
Keywords: Arterial supply, Caecum, Appendix, Fetuses, Adults

Appendix pathology brings together different forms and is found in different age segments. Most susceptible to disease are children. In this context, the children and young people Appendix pathology may be complicated or can be... more

Appendix pathology brings together different forms and is found in different age segments. Most susceptible to disease are children. In this context, the children and young people Appendix pathology may be complicated or can be accompanied by damage to adjacent organs, located in the abdominal cavity. This morphological study presents the structural aspects of normal appendix and the ulcerated appendicitis. For observation of structural aspects, has been used classic stainings. It also shows the appendix using immunohistochemical technique.

Recent advances in the management of appendiceal mucinous neoplasms (AMN) such as peritonectomy combined with hyperthermic intraperitoneal chemotherapy have introduced new standards of care. However, many dilemmas are encountered in... more

Recent advances in the management of appendiceal mucinous neoplasms (AMN) such as peritonectomy combined with hyperthermic intraperitoneal chemotherapy have introduced new standards of care. However, many dilemmas are encountered in decision making as in the following patient. A 74-year-old woman was admitted with an appendiceal cystadenoma found in a preadmission CT scan. However, the tumour was not documented by the in hospital investigation due to its perforation and its reduction in size. Consequently, a series of management dilemmas were encountered that were solved by cautious evaluation of the pre and peroperative findings. She was submitted to a right hemicolectomy. A spontaneous perforation was suspected, but the accurate diagnosis was documented postoperatively by histopathology. This paradigm motivated this review which concluded that reasoning clinical decisions in the light of recent advances and appropriate care based on the disease-stage are essential for an optimal o...

Background: This study identifies the incidence of appendiceal Enterobius vermicularis (E.v) infestation in all the patients undergoing appendectomy and evaluates the relationship between E. v infestation of the appendix and the acute... more

Background: This study identifies the incidence of appendiceal Enterobius vermicularis (E.v) infestation in all the patients undergoing appendectomy and evaluates the relationship between E. v infestation of the appendix and the acute appendicitis. Method: ology: All the routinely examined appendectomy specimens received in the pathology laboratory of a referral hospital over a three year period of time were reviewed for the existence of E. v. These cases were evaluated for clinico-laboratory characterization. Results: Out of 1150 appendectomies for clinical acute appendicitis picture, 31 (2.7%) cases revealed E. v infestation. The age ranged from 6 to 42 years old but more than 80% of the E. v infected cases were children. Twenty four cases (77.4%) did not show any other appendiceal pathology, six cases showed lymphoid hyperplasia and only one case showed concomitant histological acute inflammatory process. Conclusion: E. v infestation is an incidental finding during histopathology examination of appendectomy specimens for patients with clinical diagnosis of acute appendicitis, however there is no relation between the existence of E. v and occurrence of acute appendicitis which is the main indication for appendectomy, so further studies are recommended to reach out earlier diagnosis to eliminate the unnecessary surgical intervention. Also surgeons should consider E. v as a differential diagnosis when removing a normal looking appendix to take the necessary precautions for minimizing any chance of contamination and sending all the normal looking appendectomy specimens for histopathology examination.

Acute Appendicitis remains the most common surgical emergency of the abdomen, and though it can present at any age, usually occurs in children and young adults. Despite tremendous advancements is surgical technique, the peritonisation of... more

Acute Appendicitis remains the most common surgical emergency of the abdomen, and though it can present at any age, usually occurs in children and young adults. Despite tremendous advancements is surgical technique, the peritonisation of the stump of the appendix remains a challenge and is especially more so when the base is perforated, gangrenous, or sloughed out. In these conditions, surrounding tissues are compromised and cannot be relied upon to heal thoroughly, with a high rate of morbidity, including the dreaded fecal fistula. The adjacent cecum, thickened and indurated by the inflammatory process is also liable to ischemia, making the management challenging when the base of the appendix is involved in the pathology, which fortunately is a rare occurrence. Here is reported the case of a young male patient with appendicitis with a sloughed base, and a review of literature regarding the ideal management of the condition.

Young rabbit appendix is a homologue of chicken bursa of Fabricius; both are crucial sites for preimmune B-cell repertoire diversification. Here, we report that appendix regulates precursor lymphocyte recruitment for further development... more

Young rabbit appendix is a homologue of chicken bursa of Fabricius; both are crucial sites for preimmune B-cell repertoire diversification. Here, we report that appendix regulates precursor lymphocyte recruitment for further development by modulating the sites of extravasation. The total area of peripheral node addressin-positive (PNAd+) high endothelial venules (HEVs) increased from 1 day to 1 week after birth, remained constant up to 2 weeks and declined to a low and persistent amount by 3 weeks. In normal 1-week and manipulated 5-week appendix where growth of follicles was retarded, PNAd+ HEVs were present in the basolateral sides of B-cell follicles whereas, in normal 5-wk-appendix these were restricted to T-cell areas. The PNAd was expressed on the lumenal surface of HEVs. The proportions of CD62L+ B cells in appendix declined from ∼40% at 3 days to 2–3% at 4 weeks. In lymphocyte transfer experiments, CD62L+ B cells were preferentially recruited compared with CD62L− B cells, anti-PNAd antibody blocked migration of B cells by ∼50%, and 100 times more B cells were recruited in 1-week compared to 6-week appendix. Thus, a unique spatiotemporal expression pattern of PNAd+ HEVs is associated with development of B-cell follicles. This regulates migration of blood-borne B-lymphocytes into developing appendix by interacting with CD62L.

The tendency is to use small cannulas for operative laparoscopy; however, working with these cannulas may have technical limitations. We developed a technique for performing appendectomy combining culdoscopy and minilaparoscopy. It uses... more

The tendency is to use small cannulas for operative laparoscopy; however, working with these cannulas may have technical limitations. We developed a technique for performing appendectomy combining culdoscopy and minilaparoscopy. It uses 3- or 5-mm abdominal cannulas, and the large 10- or 12-mm cannula is inserted into the posterior vaginal fornix under laparoscopic surveillance. The vaginal port is used to

De Garengeot hernia is defined as femoral hernia containing appendix. An acute appendicitis in a femoral hernia is a extremely unusual surgical finding and occurs in 0.08%-0.013% of all cases. We report the case of an elderly woman, who... more

De Garengeot hernia is defined as femoral hernia containing appendix. An acute appendicitis in a femoral hernia is a extremely unusual surgical finding and occurs in 0.08%-0.013% of all cases. We report the case of an elderly woman, who presented with a typical clinical image of incarcerated femoral hernia and underwent open surgery. An infrainguinal incision was performed and after the dissection of hernia sac, an acute appendicitis within femoral hernia was revealed. Subsequently, appendectomy and hernioplasty were performed. Acute appendicitis within femoral hernia should be included in differential diagnosis of patients presenting with clinical signs of an incarcerated femoral hernia and prompt surgical treatment is essential in order to avoid severe complications.

Intussusception of the appendix in adult represents an uncommon entity. We report a 54-year old woman who underwent an appendectomy 24 years previously and who was hospitalized for changes in bowel habits and periumbilical and epigastric... more

Intussusception of the appendix in adult represents an uncommon entity. We report a 54-year old woman who underwent an appendectomy 24 years previously and who was hospitalized for changes in bowel habits and periumbilical and epigastric pain. A sessile polypoid tumor of cecum was discovered during colonoscopy, which was removed. Histopathological examination showed that it was the case of an inverted appendiceal stump. Authors present reviews of the literature concerning clinical features, associated conditions, diagnosis, classification and therapy of this extremely rare condition.