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ISRN Anatomy  2014 

Variations in the Position and Length of the Vermiform Appendix in a Black Kenyan Population

DOI: 10.1155/2014/871048

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Abstract:

Background. Topography of the appendix influences its mobility, degree of mobilization of the cecum, and need for additional muscle splitting during appendectomy. Although appendectomy is a common surgical procedure, there is a paucity of data on its topography in black Africans. Methods. The position and length of the appendix and relation of the appendicular base with spinoumbilical line were determined in 48 cadavers obtained from the Department of Human Anatomy, University of Nairobi, Kenya. Results. The commonest appendicular types in males were retrocecal 10 (27%) while in females was subileal 4 (36.4%). The average length of the appendix was 76.5 ± 23.6?mm. The base of the appendix was located along, below, and above the spinoumbilical line in 25 (52.1%), 9 (18.8%), and 14 (29.2%) cases, respectively. Conclusion. The topography of appendix in Kenyans shows variations from other populations. Knowledge of these variations is important during appendicectomy. 1. Introduction The vermiform appendix is the most variable abdominal organ in terms of position, extent, peritoneal, and organ relations [1–4]. Knowledge of the variations in the position of the vermiform appendix is important because, in appendicitis, its variable positions may produce variable symptoms and signs which mimic other diseases [5–7]. Further, understanding of these variations is important during other intra-abdominal procedures [4, 8]. The length of the vermiform appendix is important in influencing the differential diagnosis of acute abdomen [2]. Ethnic and geographical variations have been reported regarding the position of the appendix (Table 1). This variable anatomy may pose a challenge during appendectomy because it may necessitate extension of a transverse incision or additional muscle splitting. Both these may complicate the surgery, prolong the operating time, and can affect the cosmetic outcome [9]. Awareness of these variations is therefore important for preoperative planning. Although appendectomy still remains one of the most commonly performed surgical procedures in Kenya [10–12], there is still scarcity of data on variant anatomy of the vermiform appendix in Kenyans. This study therefore aimed to investigate the topography of the appendix in a black Kenyan population. Table 1: Positions of appendix in various populations. 2. Materials and Methods Forty-eight human cadavers (37 males) obtained during routine dissection in the Department of Human Anatomy, University of Nairobi, were studied. Ethical approval was obtained from the Kenyatta National Hospital/University

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