Observational assessment of anatomical variations of the appendix and their surgical relevance in complicated appendicitis cases. A cross-sectional study.

Nilam K  Meghatar; Bhadresh  Prajapati

doi:10.51168/sjhrafrica.v6i6.1923

Authors

Dr. Nilam K Meghatar Associate Professor, Department of Anatomy, GMERS Medical College, Himmatnagar, Sabarkantha, Gujarat, India.
Bhadresh Prajapati Associate Professor, Department of Anatomy, Government Medical College, Surat,Gujarat, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1923

Keywords:

Appendix, anatomical variation, complicated appendicitis, retrocecal, pelvic, perforation, abscess, intraoperative findings, surgical relevance

Abstract

Background
Anatomical variations in the position of the appendix may influence the clinical presentation, diagnosis, and surgical outcomes of complicated appendicitis. Accurate knowledge of these variations is crucial for timely intervention and improved patient outcomes.

Objectives

To assess the anatomical variations of the vermiform appendix and analyze their association with surgical findings and complications in patients with complicated appendicitis.

Methods

This observational study was conducted on 100 patients diagnosed intraoperatively with complicated appendicitis at a tertiary care hospital. Patient demographics, type of complication, appendix position, intraoperative difficulties, and histopathological findings were recorded. Data were presented using descriptive statistics and tabulated.

Results

The mean age of patients was 28.6 ± 10.4 years; 64% were male. Perforated appendix (39%) and appendicular abscess (27%) were the most frequent complications. Retrocecal position was the most common anatomical variant (48%), followed by pelvic (24%) and subcecal (12%). Atypical appendix positions (post-ileal and pre-ileal) were associated with delayed diagnosis, increased operative time (mean: 68.2 ± 12.7 minutes), and higher conversion rates to open surgery (39.3%). Histopathology confirmed transmural inflammation in 86% and gangrenous changes in 14% of cases.

Conclusion

Anatomical variations in appendix position significantly influence the severity and type of complications in appendicitis. Retrocecal and pelvic positions were most common and often associated with perforation and abscess formation, respectively. Awareness of these variations is essential for prompt diagnosis and optimal surgical management in complicated cases.

Recommendations

Preoperative imaging and intraoperative vigilance are recommended to anticipate anatomical variation and reduce surgical morbidity and delay.

Author Biographies

Dr. Nilam K Meghatar, Associate Professor, Department of Anatomy, GMERS Medical College, Himmatnagar, Sabarkantha, Gujarat, India.

Is an Associate Professor in the Department of Anatomy at GMERS Medical College, Himmatnagar, Sabarkantha, Gujarat, India. She completed her MBBS from M.P. Shah Medical College, Jamnagar, Gujarat, in 2006 (Registration No: G-39012) and her MD in Anatomy from Government Medical College, Surat, Gujarat, in 2011 (Registration No: G-18536). With over 15 years of teaching experience, she has published several articles in indexed national and international journals. ORCID ID: https://orcid.org/0009-0004-5988-3407

Bhadresh Prajapati, Associate Professor, Department of Anatomy, Government Medical College, Surat,Gujarat, India.

Is currently serving as an Associate Professor in the Department of Anatomy at Government Medical College, Surat. He completed his MBBS from Surat Municipal Institute of Medical Education and Research, Surat, and earned his MD in Anatomy from Government Medical College, Surat. With over 14 years of teaching experience, he has been actively involved in educating undergraduate medical students and mentoring their academic growth. Dr. Bhadresh has published six research papers in reputed anatomical journals, contributing significantly to the advancement of anatomical science. ORCID ID: https://orcid.org/0009-0005-8699-1910

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