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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2005 August;18(4):211-4
Associated anomalies of the vermiform appendix. Description and discussion of one case
Simoncini F., Barugola G., Migliara B., Lipari G., Landoni L., Baggio E.
Associated anomalies of the vermiform appendix are an extremely rare intraoperative finding. The authors report a case of associated anomalies of the appendix which was observed in a 58-year-old male patient who was admitted to the Surgery Department presenting a picture of acute pain in the side and in the region of the right iliac fossa. After carrying out a surgical approach by way of a right pararectal incision the appendix was not found in its usual location but it was found to be oriented upwards with the base of the system on the lateral face of the ascending colon and subhepatic cranial apex. This finding was associated with the presence of a final retroperitoneal loop and histological examination of the operating specimen not only confired the diagnosis of acute appendicitis but pointed to the presence of an associated diverticulum which was perforated into the bargain. From a review of the very recent literature, these anomalies would appear to be extremely rare considering the scanty number of cases reported in the literature. The anatomy and embriology, as already described by other colleagues, and the possible pathogenetic hypotheses that have been advanced to explain these anomalies are synthetically presented; finally the clinical aspects, diagnosis procedures, histopatological picture and surgical treatment are described. At the conclusion of the discussion, some remarks are made about the presence of the diverticulum in the appendix as a key factor in the triggering of the acute inflammatory event.