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BMJ Case Reports Sep 2023The vermiform appendix (VA) is known to exhibit a wide range of anatomic variability, with clinical presentation correlating with certain known anatomic positioning. To...
The vermiform appendix (VA) is known to exhibit a wide range of anatomic variability, with clinical presentation correlating with certain known anatomic positioning. To the best of our knowledge, we describe the second known case of a retro-psoas muscle VA variant and the first known case of appendicitis in such a location. Retroperitoneal access was obtained, and the appendix was freed from the intermuscular recess between the psoas and iliacus. The peritoneal defect was primarily repaired, and the patient was discharged on postoperative day 1 in good condition.
Topics: Humans; Appendicitis; Appendix; Abdominal Muscles; Patient Discharge; Peritoneum
PubMed: 37730427
DOI: 10.1136/bcr-2022-253128 -
Advances in Experimental Medicine and... 2020The pathological features of the appendix tumors fundamentally recall those of the more frequent colorectal neoplasms, although with a higher relative incidence of... (Review)
Review
The pathological features of the appendix tumors fundamentally recall those of the more frequent colorectal neoplasms, although with a higher relative incidence of carcinoids, due to the abundant presence of enteroendocrine cells in the appendix wall. Moreover, different types of lymphomas, Hodgkin and non-Hodgkin, arising from the extra-nodal mucosal-associated lymphatic tissue, can be encountered. The appendix tumor microenvironment (TME) consists of a cellular component and of a noncellular component: the former includes the immunocompetent cells, while the latter represents the support stroma. Particularly in carcinoids, the immune cell reaction can be explicated by tumor-infiltrating lymphocytes, which, in some circumstances, may arrange around and inside the tumor in a brisk fashion influencing favorably the prognosis. This active reaction has to be distinguished from any preexisting inflammatory condition of the appendix and from superimposed tumor complications, such as infection or ischemia. In practice, we consider the appendix TME a complex framework with immunological, mechanic, and metabolic functions, all supported by a marked neo-lymphoangiogenesis.
Topics: Appendiceal Neoplasms; Appendix; Carcinoid Tumor; Humans; Prognosis; Tumor Microenvironment
PubMed: 32030678
DOI: 10.1007/978-3-030-36214-0_7 -
Khirurgiia 2022Appendiceal cancer is one of the rarest tumors. In most patients, this disease is diagnosed during appendectomy or after autopsy. The authors report a patient with...
Appendiceal cancer is one of the rarest tumors. In most patients, this disease is diagnosed during appendectomy or after autopsy. The authors report a patient with appendiceal cancer identified during the treatment of appendicular infiltrate and analyze literature devoted to this issue. Clinical case confirms that appendiceal cancer is difficult for differential diagnosis due to peculiarities and variability of its course. This aspect prevents timely treatment of disease. Timely and accurate diagnosis requires not only clinical experience, but also introduction of new technologies and clinical tests that could reduce the risk of damage and increase the accuracy of diagnostic data.
Topics: Appendectomy; Appendiceal Neoplasms; Appendicitis; Appendix; Diagnosis, Differential; Humans
PubMed: 35147005
DOI: 10.17116/hirurgia202202179 -
Radiologic Technology Jul 2018Near the ileocecal valve, at the junction of the small intestine and large intestine, lies a blind-ended tube and possible homeostatic regulator called the vermiform... (Review)
Review
Near the ileocecal valve, at the junction of the small intestine and large intestine, lies a blind-ended tube and possible homeostatic regulator called the vermiform appendix. The organ can cause several abdominal maladies that, if left untreated, can result in a complicated recovery or death. Imaging professionals should understand the structure and function of the entire gastrointestinal tract to provide optimal care for patients undergoing diagnostic imaging. This article provides a brief overview of gastrointestinal anatomy, appendix physiology and function, clinical evaluation, appendix imaging, and treatment of appendicitis.
Topics: Appendicitis; Appendix; Diagnosis, Differential; Humans; Technology, Radiologic
PubMed: 30420527
DOI: No ID Found -
Radiology Dec 2023
Topics: Humans; Fistula; Appendix
PubMed: 38112543
DOI: 10.1148/radiol.231939 -
Surgical Infections Sep 2021Considered vestigial from the classic point of view, the vermiform appendix has long been the subject of intensive studies. The recent understanding of appendix... (Review)
Review
Considered vestigial from the classic point of view, the vermiform appendix has long been the subject of intensive studies. The recent understanding of appendix function in the context of unique architecture and bacterial complexity and density allows considering it as a safehouse for intestinal biodiversity. This review analyzes and assesses the current state of scientific knowledge regarding the role of the vermiform appendix in normal gut microbiota maintenance as a crucial factor of host homeostasis. It also highlights the difference in microbial composition between the large bowel and the appendix, as well as the association between the surgical excision, appendectomy, and dysbiosis-induced diseases. In addition, the review discusses the results of epidemiologic studies on appendectomy as a risk factor for the initiation of gastrointestinal carcinogenesis. It also highlights the association between appendectomy and a series of chronic inflammatory and neurologic disorders, including inflammatory bowel disease.
Topics: Appendectomy; Appendix; Dysbiosis; Gastrointestinal Microbiome; Humans; Inflammatory Bowel Diseases
PubMed: 33523761
DOI: 10.1089/sur.2020.422 -
Pediatric Radiology Aug 2017Appendicitis is the most common pediatric surgical emergency. Ultrasound (US) receives the highest appropriate rating scale in children with right lower quadrant pain... (Review)
Review
Appendicitis is the most common pediatric surgical emergency. Ultrasound (US) receives the highest appropriate rating scale in children with right lower quadrant pain suspected to have appendicitis. The US exam of the appendix has improved since Puylaert pioneered the technique of graded compression in 1986. In this article, we review ultrasonography of the pediatric appendix as it pertains to the normal appendix, acute appendicitis and the different sonographic manifestations. We also briefly describe technical optimization of image acquisition, common pitfalls and differential diagnoses.
Topics: Abdominal Pain; Appendicitis; Appendix; Child; Child, Preschool; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Ultrasonography
PubMed: 28779198
DOI: 10.1007/s00247-017-3928-4 -
Abdominal Radiology (New York) Jan 2019
Review
Topics: Acute Disease; Appendicitis; Appendix; Diagnosis, Differential; Humans; Ultrasonography
PubMed: 29987400
DOI: 10.1007/s00261-018-1698-6 -
Pediatric Surgery International Apr 2016Incidental appendectomy is the removal of the vermiform appendix accompanying another operation, without evidence of acute appendicitis. It is generally performed to... (Review)
Review
Incidental appendectomy is the removal of the vermiform appendix accompanying another operation, without evidence of acute appendicitis. It is generally performed to eliminate the risk of future appendicitis. The risks and benefits of incidental appendectomy during various operations in children have been debated for over a century, but need to be revisited in light of innovations in medical practice, including minimally invasive surgery, improved imaging techniques, and use of the appendix as a tubular conduit for reconstruction. A detailed review was undertaken of the techniques, pathology, risks of appendectomy, utility of the appendix, and incidental appendectomy in the treatment of specific pediatric medical conditions. A comprehensive literature search was performed, and retrieved results were reviewed for relevance to the topic. The decision to perform a pediatric incidental appendectomy relies on informed consideration of the individual patient's co-morbid conditions, the indication for the initial operation, the future utility of the appendix, and the risk of future appendiceal pathology. The discussion includes a variety of situations and comorbid conditions that may influence a surgeon's decision to perform incidental appendectomy.
Topics: Appendectomy; Appendicitis; Appendix; Child; Humans
PubMed: 26590816
DOI: 10.1007/s00383-015-3839-0 -
Emergency Radiology Oct 2014The appendix may demonstrate a perplexing range of normal and abnormal appearances on imaging exams. Familiarity with the anatomy and anatomical variants of the appendix... (Review)
Review
The appendix may demonstrate a perplexing range of normal and abnormal appearances on imaging exams. Familiarity with the anatomy and anatomical variants of the appendix is helpful in identifying the appendix on ultrasound, computed tomography, and magnetic resonance imaging. Knowledge of the variety of pathologies afflicting the appendix and of the spectrum of imaging findings may be particularly useful to the emergency radiologist for accurate diagnosis and appropriate guidance regarding clinical and surgical management. In this pictorial essay, we review appendiceal embryology, anatomical variants such as Amyand hernias, and pathologies from appendicitis to carcinoid, mucinous, and nonmucinous epithelial neoplasms.
Topics: Acute Disease; Adult; Aged; Anatomic Variation; Appendiceal Neoplasms; Appendicitis; Appendix; Carcinoid Tumor; Diagnostic Imaging; Female; Humans; Male; Middle Aged; Radiography
PubMed: 24570122
DOI: 10.1007/s10140-014-1206-4