On the anatomy of the appendix among adult black Zimbabweans

Abstract

Objectives: To determine the position, length and diameter of the appendix and the extent of attachment of its mesoappendix among adult black Zimbabweans.

Design: Descriptive cross sectional study.

Setting: Parirenyatwa Group of Hospitals, Harare, Zimbabwe.

Subjects: Consecutive cases of adult black Zimbabweans who underwent a post mortem examination between May and September 2016.

Results: A total of 100 subjects were used, 68 males and 32 females giving a male to female ratio of 2:1. The mean age was 41.8+17.10 years. The most common position of the appendix was retrocolic/retrocecal (51%), followed by the pelvic position (34%). The average length of the appendix was 12.3+3.21 cm. The average external diameter of the appendix was 0.74cm+0.10 cm. The diameter of the appendix decreased from its base to its tip. The mesoappendix reached the tip of the appendix in 75% of the subjects while it failed to reach the tip in the remaining 25%. The length and diameter of the appendix showed negative correlations with age (r=- 0.254 and r=-0.057 respectively) and these were not statistically significant (p=0.28 and p= 0.811 respectively).

Conclusion: In contrast to previous Sub-Saharan African studies, the retrocolic position was the most common and the average length of the appendix (12.3±3.21cm) was larger than the average lengths reported in the literature (5-10cm).The mesoappendix extended the whole length of the appendix in 75% of the subjects. These observations suggested that the clinical presentation of acute appendicitis among adult Zimbabweans may be different from the classical presentation in the literature. In retrocolic presentation, right loin pain is often present, and is associated with tenderness on examination.