Dados do Trabalho

Título

Appendix Positions and their Clinical Implications: Literature Review

Introdução

The anatomical variations of the appendix are the cause of most unforeseen events in appendectomies, in addition to other surgical procedures, and are related to atypical clinical manifestations.

Objetivo

To present the anatomical variations of the appendix and their clinical, diagnostic and therapeutic repercussions, based on a systematic literature review.

Método

A systematic review of articles carried out in the PubMed database in March 2021, using the descriptors: "appendix", "appendiceal", "variation", "anatomical", "abnormal position" and “appendicitis”. All studies published between 2012 and 2021 that presented appendicular anatomical variations were included, and after excluding those that did not relate anatomical aspects to clinical and/or diagnostic and/or therapeutic aspects, 5 studies were selected to the analysis.

Resultados

In cases of mobile cecum, atypical clinical features and diagnostic difficulties can be observed, with computed tomography (CT) being useful. In cases of intracecal appendix, the usefulness of CT has not been established. The lateral bag type may present, in addition to the variable clinical features, difficulties in laparoscopy. Appendix duplication should be evaluated as a differential diagnosis even if reported previous appendectomy.

Conclusão

Cecum and appendix’s anatomical variations may be related to the atypical clinical presentation of acute appendicitis or concomitant visceral anomalies, being knowledge of the variations, CT and surgical inspection useful in the location’s identification of cecum and appendix, avoiding diagnostic and conduct errors, manual inability, severe complications and medico-legal judicial demands.

Palavras-Chave

Appendix. Appendix cecal. Vermiform appendix. Anatomical variation. Appendicitis.