Kasukurthy Ashalatha1, Arunkumar S. Bilodi2, Prasad K. S. N3
Appendix is derived from a Latin word (Pendere) meaning at the end. It is a narrow worm-like tubular diverticulum, which arises from the posteromedial wall of caecum about 2 cms below the ileocaecal junction and is suspended by a peritoneal fold known as mesoappendix. The body of appendix is kinked on itself where the free border of mesoappendix ends. Hence, it is coiled like a worm and so is named the ‘Vermiform Appendix’. The appendix is taken up for study in view of its different positions, varying anatomical relations, and the clinical complications when pathologically affected. The relations, measurements, positions, and arterial supply were studied by gross dissection in 61 specimens (Adults – 33 and foetuses – 28) from the population of Krishna and Warangal districts of Andhra Pradesh.
MATERIALS AND METHODS
The present study was done on 31 adult specimens, out the length of the appendix, the diameter of the appendix at base, length of the caecum, length of ascending colon were measured. The position of the appendix was classified as per Datta’s classification. Mesenteric attachment to the vermiform appendix were noted. Even arterial supply of the appendix was studied.
Length of the appendix in adults varied from 2.00 to 25.00 cm as described by different authors, the average being 3.00 to 12.50 cm. The length of the caecum in adults were ranging from 5 to 8 cm. In the present study, the length of appendix was 14.4 cm The origin of the appendicular artery was from inferior division of ileocolic artery. A single appendicular artery is observed in all the specimens almost coinciding with studies of Michels et al. In the present study, in adults, the mesoappendix was extending to the tip in 19 specimens and extending to a variable extent in 14 specimens. Regarding the positions, in adults, they were retrocaecal, retrocolic, and subcaecal positions were 21.21% and splenic, promontory, and pelvic positions were 78.8%.
The knowledge of anatomy of appendix is very important for thorough understanding of the pathology, signs, and symptoms of acute appendicitis. This study of different positions and gross features of vermiform appendix will be of great help to the surgeons when they do laparotomy and plan for further any surgical procedures.