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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Vermiform Process (Appendix)

Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Digestive System and Spleen

Vermiform Process (Appendix)

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed

The appendix may be found almost anywhere in the abdominal cavity depending upon its development and the rotation of the gut. In situs inversus it will be found in the lower left quadrant of the abdomen.

Depending on its length, it may lie in the true pelvis.

It usually varies in size from less than 5mm (1/4 inch) to 230mm (9 1/4 inch) in length. According to Broedel, the longest appendix recorded was 33 cm (13 inches) (Kelly and Hurndon)

The appendix may be absent or duplicated.

Three appendices in one individual has been reported.

Appendicular diverticula may occur. Berengario da Carpi (1523) was the first to describe the caecal appendix.

Image 8 Positions of Vermiform Appendix

Image 9 Case of Colonic Hyper-Rotation

Image 10 Four Types of Cecum

Image 71 Left-sided Vermiform Appendix


Anson, B.J., Lyman, R.Y. and H.H Lander. (1936) The abdominal viscera in situ. A study of 125 consecutive cadavers. Anat. Rec. 67:17-21.

Berry, R.J.A. (1895) The anatomy of the vermiform appendix. Anat. Anz. 10:761-769.

Berry, R.J. and L.A.H. Lack. (1906) The vermiform appendix of man, and structural changes therein coincident with age. Anat. Physiol. 40:247-256.

Calori, L. (1880) Di un inversione splancnica generale nell'uomo accompagnata do alcuni notabili del capo con esso lei convenienti e da estrance anomalie. Mem. R. Accad. Sci. Istituto di Bologna S.4., 2:597-622.

Capone, A.J. and H. Miller. (1946) Left-sided appendicitis in a dextro cardiac patient. Am. J. Surg. 71:282-283.

Cave, A.J.E. (1935-36) Appendix vermiformis duplex. J. Anat. 70:283-292.

Clado, -. (1892) Appendice caecal. Soc. Biol. Comptes Rendus Hebdomadaires des Séances et Mémoires 44:133-172.

Collins, D.C. (1936) Diverticula of the vermiform appendix: A study based on thirty cases. Ann. Surg. 104:1001-1002.

Collins, D.C. (195 1) Agenesis of the vermiform appendix. Am. J. Surg. 82:689-696.

Coloton, E.J., Anson, B.J., Gibbs, E.W., McCormack, L.J., Reimann, A.F. and E.H. Daseler. (1947) Positions of abdominal viscera. Q. Bull. Northwestern University Medical School. 21:154-155.

Dixon, A.F. (1897) A rare condition of the vermiform appendix. J. Anat. Physiol. 31:442-445.

Donald, C. (1927-28) Volvulus of small gut, caecum, and ascending colon associated with congenital reversed rotation of intestine and with pregnancy. Brit. J. Surgery 15:269-272.

Elias, E.G. and R. Hults. (1967) Congenital absence of vermiform appendix. Arch. Surg. 95:257-258.

Fawcett, E. (1895) An unusually large terminal vermiform appendix, with recurved small conical caecum; with some remarks on the peritoneal pouches. J. Anat. Physiol. 29:498-500.

Giannelli, L. (1904) Notes anatomiques sur l'appendice caecal. Arch. Ital Biol. 41:474.

Gladstone, R.J. (1915) Congenital absence of the appendix of the caecum. J. Anat. Physiol. 69:414-417.

Gladstone, R.J. and C.P.G. Wakeley. (1923-24) The relative frequency of the various positions of the vermiform appendix: As ascertained by an analysis of 3,000 cases: with an account of its development. Brit. J. Surgery 11:503-520.

Hedinger, E. (1904) Kongenitale Divertikelbildung im Processus vermiformis. Arch. Pathol. Anat. Physiol. Klin. Med. 178:25-43.

Herrligkoffer, K.M. (1943) Abnorme Lage des Processus vermiformis bei Hochstand des Caecum. Anat. Anz. 94:313-317.

Jelesuevic, V. (1974) Diverticulum processus vermiformis. Anat. Anz. 135:226-234.

Kelly, H.A. and E. Hurdon. (1905) The Vermiform Appendix and its Diseases. W.B. Saunders & Company, Philadelphia and London.

MacPhail, S.R. (1917 Note on the length of vermiform process in 220 consecutive post-mortem examinations. J. Anat. 51:308.

Maisal, H. (1960) The position of the human vermiform appendix in fetal and adult age groups. Anat. Rec. 136:385-389.

Perruchio, P., Mollaret, L., Soutoul, J. and G. Baud. (1958) Note à propos d'un cas de duplicité de l'appendiculaire vermiforme et d'un diverticule coecal pseudoappendiculare. Assoc. Anatomistes Comptes Rendus 45:643-646.

Pester, G.H. (1965) Congenital absence of the vermiform appendix. Arch. Surg. 91:461-462.

Robinson, J.O. (1951-52) Congenital absence of vermiform appendix. Brit. J. Surg. 39:344-345.

Saare, J.J. (1955) Absence of the vermiform appendix (report of a case of necropsy). Acta Anat. 23:327-329.

Schridde, H. (1904) über den angeborenen Mangel des Processus vermiformis. Arch. Pathol. Anat. Physiol. Klin. Med. 177:150-166.

Schrup, J.H. (1915) Left-sided appendix. Surg. Gynecol. Obstet. 21:442-446.

Singleton, A.O. and W.B. King. (1951) Persistent vitelline duct continous with the appendix. Surgery 29:278-280.

Solanke, T.F. (1970) The position, length, and content of the vermiform appendix in Nigerians. Brit. J. Surg. 57:100-102.

Treves, F. (1885) Anatomy of the intestinal canal and peritoneum in man. Brit. Med. J. i:470-474.

Tyson, W.J. (1896) A vermiform appendix eight inches long containing a concretion. Trans. Path. Soc. Lond. 47:51

Velluda, C.C. (1936) Absence du caecum et de ll'appendice iléo-caecal, de la valvule iléo-caecal et des bandelletes musculaires du côlon ascendent chez l'homme. Ann. Anat. Pathol. 13:1030-1033.

Wakeley, C.P.G. (1933) The position of the vermiform appendix as ascertained by an analysis of 10,000 cases.

Walmsley, T. (1929) A diverticulum of the appendix. J. Anat. 64:47-49.

Watt, J.K. (1958-59) Appendix Duplex. Brit. J. Surg. 46:472-473.

Waugh, T.R. (194 1) Appendix vermiformis duplex. Arch. Surg. 42:311-320.

Wright, C.W. (1955) A case of left-sided vermiform appendix, cecum and anomalous colon. Anat. Rec. 123:291-298.

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