Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Appendix”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Growing of caecum and vermiform appendix during the fetal period.

OBJECTIVE: The aim of this study is to investigate the growing of the caecum and the vermiform appendix during the fetal period in human fetuses and the relation between growing and shape of the caecum and the localization of the vermiform appendix. METHODS: 40 male and 40 female externally normal-looking fetuses were studied between 10 and 40 weeks of gestation and were subdivided into fetuses of the 1st, 2nd, and 3rd trimesters and full-term fetuses. The parameters of interest included covering of the caecum with peritoneum, shape of the caecum (long tube, symmetric saccule, asymmetric saccule, extremely large right side--atypical), axial length and width of the caecum localization of the vermiform appendix, length of vermiform appendix and length of the meso-appendix. RESULTS: There was a difference in covering of the caecum with peritoneum between males and females; the caecum was predominantly tube shaped during the fetal period, with the asymmetric saccule towards the end of the fetal period; the localization of the vermiform appendix was subcaecal (39%) during the fetal period and postileal (34%) in female fetuses and subcaecal (48%) in male fetuses--the localization of the vermiform appendix changed according to the caecum shape during the fetal period; we found significant differences in the measurements of vermiform appendix, meso-appendix, and caecum among 1st-, 2nd-, and 3rd-trimester fetuses and full-term fetuses. CONCLUSIONS: There was an increase in the measurements for vermiform appendix, meso-appendix, and caecum with increasing gestational age; the localization of the vermiform appendix depended on the shape of the caecum, was different from that of adults and different between sexes, and there was also a significant difference in covering of the caecum with peritoneum between both sexes.

Appendix↗
PubMed2006

Localization of appendix with MDCT and influence of findings on choice of appendectomy incision.

OBJECTIVE: The purpose of this study was to show the relation between McBurney's point and the appendix in patients undergoing 3D MDCT and to investigate the effect of this information on a surgeon's choice of appendectomy incision. MATERIAL AND METHODS: Among 142 adults undergoing consecutive MDCT studies, 100 patients (35 women, 65 men; mean age, 52.1 years) with an identifiable appendix on abdominopelvic MDCT examinations were selected for the study group. The presence of intraabdominal mass or a history of abdominal surgery were the exclusion criteria. Three-dimensional reconstruction of the CT data was performed with a surface shaded display algorithm. The locations of the base of the appendix and McBurney's point were marked on a single 3D image that allowed display of the skin surface markings for each patient. The superoinferior and mediolateral distances from the level of the appendix to the level of McBurney's point were measured, and the radial distance was calculated from these measurements. A surgeon experienced in emergency abdominal surgery reviewed 3D CT images and one axial image showing the appendix, and his choice of incision for each patient based on the CT information was recorded. The influence of the superoinferior and mediolateral distances of the appendix from McBurney's point on the surgeon's decision was analyzed with a multivariate logistic regression model. RESULTS: The appendix was exactly at McBurney's point in only 4% of the patients. In 36% of the cases, the appendix was within 3 cm, in 28% of cases it was 3-5 cm, and in 36% of the cases it was more than 5 cm away from McBurney's point. Mean +/- SD superoinferior, mediolateral, and radial distances between the appendix and McBurney's point were 33.0 +/- 24.1, 20.8 +/- 19.3, and 42.1 +/- 26.7 mm, respectively. After reviewing the images, the surgeon would have altered his incision site in 35% of the cases. The surgeon preferred a higher incision in 28% and a lower incision in 7% of the cases. Both positive and negative superoinferior displacement away from McBurney's point were significant factors regarding the surgeon's decision to alter the incision (p = 0.005), and the superoinferior distance was more than 3 cm in 94% of the cases in which the surgeon would have altered the incision. CONCLUSION: The location of the appendix varies widely among individuals, and McBurney's point has limitations as an anatomic landmark. Three-dimensional MDCT findings can be useful to surgeons customizing appendectomy incisions. Additional information about the location of the appendix in the CT report (if possible, together with a 3D image showing the location of the appendix) may be beneficial for surgeons performing appendectomy.

Appendectomy↗
PubMed2007

Sonographic appearance of the normal appendix in adults.

OBJECTIVE: To evaluate the sonographic visualization of the normal adult appendix, a large series of sonographic images from consecutive asymptomatic patients was analyzed. METHODS: A total of 788 consecutive adult patients (402 male and 386 female; median age +/- SD, 51.1 +/- 17.2 years; range, 16-91 years) were examined by appendiceal transabdominal sonography with tissue harmonic imaging. The detection rate, outer appendiceal diameter, intraluminal content, and location of the appendix were estimated. The overall normal appendix was separated into appendix-visualized and appendix-not-visualized groups, which were then examined for the relationship with abdominal wall thickness, body mass index (in kilograms per square meter), age, and sex. RESULTS: The normal appendix was detected in 388 (49.2%) of 788 patients. The outer appendiceal diameter +/- SD was 4.27 +/- 1.2 mm (range, 1.0-11.1 mm). In 291 (75%) of the 388 patients, appendices could be depicted in the intra-luminal gas during sonography. The location of the appendix was classified according to the appendiceal tip, which was found to be abdominal in 37 (9.5%), pelvic in 291 (75%), retrocecal in 23 (6.0%), and a midline extension in 37 (9.5%). In both body mass index and abdominal wall thickness, significant differences were found between appendix-visualized and appendix-not-visualized cases (P < .05). There was no significant difference in age (P = .37) or sex (P = .23) between appendix-visualized and appendix-not-visualized cases. CONCLUSIONS: The results show that the normal adult appendix can be revealed by sonographic visualization in a large series of asymptomatic patients.

Adolescent↗
PubMed2001

Simultaneous Malone antegrade continent enema and Mitrofanoff principle using the divided appendix: report of a new technique for prevention of stoma complications.

PURPOSE: We determine the results and complications of continent urinary diversion and simultaneous Malone antegrade continent enema (MACE) and the Mitrofanoff principle using the divided appendix, and report on the VQQ and VQ technique for prevention of complications at the stoma level. MATERIALS AND METHODS: Between June 1995 and June 1999, 40 patients 4 to 22 years old (mean age 9.5) underwent Mitrofanoff procedures in conjunction with the MACE and augmentation cystoplasty as primary (5) or salvage (35) therapy. Of the patients 35 had neuropathic bladder, and 5 had bladder and bowel dysfunction without detectable neurological abnormalities. All patients had an antireflux Mitrofanoff channel constructed using distal part of the appendix with its divided mesothelium. The proximal half of the appendix was preserved as a modified MACE. Average length of appendix was 10.3 cm. (range 9 to 15) and no correlation was found between the length of appendix and age of child. The stoma construction was performed as 2 different techniques. The 2 appendix stomas were initially anastomosed with 2 separate triangular posterior V shape skin flaps on the right lower abdominal wall. Both appendix mucosae were completely buried with a single or double quadrilateral skin flap (VQQ and VQ technique). RESULTS: All patients are continent day and night without diapers. Mean followup was 22 months (range 8 to 48) and the overall incidence of complications was 7.5%. Mitrofanoff stomal stenosis due to catheter false passage occurred postoperatively in 1 case, gas leakage from the MACE in 1 and partial mucosal prolapse in 1. CONCLUSIONS: The MACE and Mitrofanoff principle have proved invaluable for the treatment of children with urinary and fecal incontinence. The divided appendix with 2 separate mesotheliums is an ideal channel for simultaneous Mitrofanoff and MACE when the appendix length is 9 cm. or more with a suitable branching mesothelium. When the appendix is short we prefer to use it as the Mitrofanoff and create a pediculed tube flap from the cecum for the MACE. All patients with a short appendix or history of appendectomy operated on by different techniques, such as the Monti procedure, Casale technique, cecal flap or ureteral Mitrofanoff, were excluded from our study. Most of the minor complications are preventable by meticulous technique. The VQQ and VQ stomas have the lowest incidence of complications and produce the most satisfactory cosmetic appearance.

Adolescent↗
PubMed2002

Improved sonographic visualization of the appendix with a saline enema in children with suspected appendicitis.

OBJECTIVE: To determine whether abdominal sonography after a saline enema can identify the appendix that is not visualized at graded compression sonography in children with suspected appendicitis. METHODS: High-frequency compression sonography was prospectively performed in 120 consecutive children with suspected appendicitis; the appendix was not identified in 27 of these patients. Among the 27 patients with a nonvisualized appendix, abdominal sonography after a saline enema was performed in 12 to identify the appendix. RESULTS: Abdominal sonography after the saline enema revealed the appendix in all 12 children in whom the appendix was not visualized at graded compression sonography. A normal appendix was found in 11 children, and acute appendicitis confined to the appendiceal tip was found in 1. The appendix was located in the pelvis (n = 5), posterior to the cecum (n = 4), posterior to the ileum (n = 2), and anterior to the ileum (n = 1). The appendix could be identified by using a window of the saline-filled sigmoid colon (n = 5), saline-filled cecum (n = 4), and saline-filled terminal ileum (n = 2). CONCLUSIONS: Abdominal sonography after a saline enema is a helpful technique for depiction of the appendix that is not visible at graded compression sonography in children with suspected appendicitis. Key words: appendix, sonography; appendicitis; children, gastrointestinal tract.

Acute Disease↗