RETROCAECAL APPENDIX

Abstract

O BJECTIVE: To study whether the different positions of appendix can affect its susceptibility to acute
inflammation. DESIGN: Prospective study. SETTING: Surgical Unit III, Bahawal Victoria Hospital, Bahawalpur.
PERIOD: 01.02.2000 to 30.10.2000. SUBJECTS & METHODS: 281 cases of acute appendicitis admitted and
operated were studied. Position and condition of appendix were noted including inflamed/highly inflamed and
normal. The incidence of hematuria/pyuria was also noted. RESULTS: The retrocaecal position was the commonest
(79%) followed by pelvic position (14%). Out of 223 cases of retrocaecal appendix, only (7%) were normal whereas
(21%) normal appendices were found in other than retrocaecal position. Advanced appendicitis was more common
in retrocaecal position (22%, p-value <0.001) as compared to other positions (10%). There was a considerable overlap
between the findings of advanced appendicitis & hematuria/pyuria especially in retrocaecal position(13%).
CONCLUSION: The different positions of appendix present as the variety of signs & symptoms in acute
appendicitis. Retrocaecal appendix, in addition to making the diagnosis of acute appendicitis more difficult, is also
more prone to infection, perforation and gangrene.