Assessment of the anatomical position of the vermiform appendix in a Sri Lankan cohort using contrast enhanced computed tomography imaging

Introduction: . Proper and advanced knowledge regarding the anatomical position of the appendix is important for radiologists, surgeons, and clinicians in diagnosing pathological conditions of the appendix.
Objectives: To assess the anatomical position, length, diameter, and luminal contents of the appendix in Contrast-Enhanced Abdominal CT (CECT) scans.
Methodology: A descriptive cross-sectional study was conducted at the Department of Radiology at Teaching Hospital Peradeniya over a period of one year, from May 2022 to April 2023. A total of 275 patients were included in the study. All abdominal CECTs among the patients who fulfilled the inclusion criteria during the study period were included. Post-contrast, a 70-second delay in the portal venous phase with a slice thickness of 1.0 mm for 3D reconstructed images was used to assess the anatomical position of the appendix. The CT scans were evaluated based on the anatomical details of the appendix, which included length, the maximum values of inner and outer diameter, and the position of the base and tip of the appendix. Descriptive statistics were used to analyze the demographic profile of the study sample.
Results: The mean age of patients was 57 years, with the majority being male (54.2%). The appendix was identified in only 87% of the abdominal CECT scans. The mean length of the appendix was 6.45 cm, and the mean inner and outer diameters were 3.90 mm and 5.49 mm, respectively. The mean length from the ileocecal valve to the base of the appendix was 2.31 cm. Approximately 42% of the appendices were located in the pelvic 5 o'clock position, while the pre-ileal 1-2 o'clock and retrocecal 11 o'clock positions were identified in approximately 28% and 11%, respectively. A statistically significant association was demonstrated between gender and the mean outer diameter of the appendix (p < 0.05).
Conclusion: The findings of the present study provide information about anatomical details of the appendix which is useful for radiologists as well as clinicians for diagnosis and treatment planning