IJCRR - Vol 05 Issue 12, June, 2013
UNDESCENDED INFANTILE CAECUM- A CASE REPORT
Author: Akhilandeswari Balasubramanian, Nandhini Venkatachalam
The Caecum is the commencement of the large intestine. It is the large cul-de-sac which lies in the right iliac fossa and continues with the ascending colon at the level of the ileal opening.[Gray’s Anatomy 2000] Normally caecum lies in on the peritoneal floor of the right iliac fossa and its lower end lies at the pelvic brim [Sinnatamby CS 1999]. The shape of caecum has been classified into four types, ie, conical 2%, quadrate 3%, 90% normal and ampullary 4% by Treves. During routine cadaveric dissection by I MBBS students at BMCRI Bangalore, a variation is seen in a 60 year old female cadaver. The caecum is conical in shape and found in the right lumbar region. Length of the caecum is 5 cm and breadth 5.25 cm. The appendix is retrocaecal and its length 6 cm. This variant shape and position of the caecum can be explained on an embryological basis. The congenital anomaly of undescended caecum gives rise to confusion in diagnosis of appendicitis. The Mc Burneys point used for locating the tenderness of appendicitis totally depends on the normal position of the base of appendix. Despite extraordinary advances in modern radiographic imaging, diagnosis of acute appendicitis remains an enigmatic challenge. A knowledge of variable positions of caecum and appendix will help in diagnosing cases of appendicitis with atypical presentations and in planning proper incisional techniques preoperatively.
Keywords: Caecum, undescended caecum, conical caecum, appendix.
Akhilandeswari Balasubramanian, Nandhini Venkatachalam. UNDESCENDED INFANTILE CAECUM- A CASE REPORT International Journal of Current Research and Review. Vol 05 Issue 12, June, 21-25
1. Williams P.L. Gray’s Anatomy -The Alimentary system. 38th ed. Newyork: Churchill Livingstone; 2000.p. 1774-1775.
2. Sinnatamby. C.S. Last’s Anatomy- Regional and Applied. 10th ed. London: Churchill Livingstone; 1999.p. 249
3. Banerjee A, Kumar IA, Tapadar A, Pranay. M. Morphological Variations in the Anatomy of Caecum and Appendix - A Cadaveric Study. National Journal Of Clinical Anatomy 2012; vol 1(1): 30-35.
4. Garis.C.F.D. Topography and development of the Cecum-Appendix. Annals of surgery 1941;vol 113(4): 540-548.
5. Delic J, Savkovic A, Isakovic E. Variations in the position and point of origin of the vermiform appendix. Med Arh.2002; 56: 5-8. (Croatian) .
6. Datta A.K. Essentials of Human Anatomy. Part I Thorax Abdomen And Pelvis, 9th ed. Kolkata: Current Books International; 2010.p. 216-219
7. Kuagoolwongse C,Chapalasiri E,Chanthong P. Undescended caecum and right sided sigmoid colon with aberrant right hepatic artery: A Case Report. Siriraj Hosp Gaz. 1992; vol 44(8): 606-609.
8. Decker .G.A.G, Plessis. D.J.D. Lee McGregor’s Synopsis of surgical anatomy. 12th ed. Mumbai: Wright Varghese; 1999.p. 22-30
9. Romanes .G.J, The abdominal cavity. Cunningham’s manual of Practical Anatomy Volume II: Thorax and abdomen, 15th ed. Newyork:Oxford University Press; 2008.p. 141-142.
10. Gardner CEJR. The surgical significance of anomalies of intestinal rotation. Ann.surg 1950;131:879-98.
11. Sahana .S.N. Human Anatomy- Descriptive and Applied. vol II 3rd ed. Calcutta: Central Book Agency; 1980.p. 299-302.
12. Snell .R.D. Clinical Anatomy. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2003.p. 246- 260