Unit:
ΠΜΣ Χειρουργική ΑνατομίαLibrary of the School of Health Sciences
Author:
Barkolias Christos
Supervisors info:
Π. Σκανδαλάκης, Καθηγητής, Ιατρική, ΕΚΠΑ
Β. Πρωτογέρου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μ. Πιάγκου, Επίκουρη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
Χειρουργική ανατομία και παραλλαγές σκωληκοειδούς απόφυσης. Εμβρυολογική βάση και χειρουργική σημασία
Translated title:
Surgical anatomy and variations of vermiformis appendix. Embryological base and surgical significance.
Summary:
The appendix vermiformis is a worm-like intestinal ture diverticulum extending from the blind end of the cecum and ending with a blind extremity with a length of 6 to 10 cm and a dimeter of less than 0.3. The mesoappendix is a fold of peritoneum around the vermiform appendix and is located close to the ileocaecal junction. It contains the appendicular artery, the vein, lymph vessels and sympathetic and parasympathetic fibres.
Histologically, the appendix mimics the wall structure of the cecum with one difference; the abundance of lymphoid tissue. The embryologic origin of the appendix is the midgut during the 6th gestational week. The development of appendix concludes early after birth. The complicated embryonic development influences the final position of the appendix. Based on published data, other factors contributing to the final position of the appendix include geographic location, life style, genotype, race and diet. Published data are often conflicting depending on the period of time and the cochrane the study was conducted.
The position of the appendix plays a significant role on the technical difficulty of any surgical treatment. Pre-operative imaging -whenever it is possible – could lead in selecting the best surgical method in order to minimize technical difficulties, provide a positive outcome and to avoid complications. Laparoscopic appendectomy presents more advantageous compared to open surgery for all positions of the appendix, including atypical ones. Open surgery may be the optimal method when the appendix is connected to the cecal wall or is located in retrocecal, paracecal and paracolic positions.
Main subject category:
Health Sciences
Keywords:
Appendix vermiformis, Appendectomy, Laparoscopic, Open, Position
