Anomalous origin of the vermiform appendix.
Appendectomy (Patient outcomes)
|Publication:||Name: South African Journal of Surgery Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 South African Medical Association ISSN: 0038-2361|
|Issue:||Date: April, 2011 Source Volume: 49 Source Issue: 2|
|Geographic:||Geographic Scope: South Africa Geographic Code: 6SOUT South Africa|
Introduction: An anomalous origin of the vermiform appendix is an
extremely rare anatomical condition. We present one such case discovered
at 'routine appendicectomy.
Case report: A 32-year-old man presented with symptoms and signs of acute appendicitis. At appendicectomy, the appendix was noted to be arising from the hepatic flexure of the colon. Histology confirmed a 7 cm long appendix specimen with intramural inflammatory cells.
Discussion: Anomalies of the vermiform appendix are very rare (<0.005%). These include agenesis, horseshoe appendix, duplication and triplication. The anomalous origin of the appendix can be explained by an embryological theory of differential growth. Caecal growth on the medial side of the appendix is more prominent than on the lateral side. This results in an ostium appendicis vermiforminis situated more cephalad and lateral on the right colon.
Conclusion: Although they are rare, a greater awareness of appendiceal anomalies is essential, especially among junior surgical residents. Failure to recognise them may result in serious clinical and medico-legal consequences.
B Dube, G R Manoharan, M Daya, S S Pillay
Livingstone Hospital, Port Elizabeth, E Cape; Walter Sisulu University, Por t Elizabeth
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