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>Journals >Cirugía y Cirujanos >Year 2009, Issue 5


Zetina-Mejía CA, Álvarez-Cosío JE, Quillo-Olvera J
Agenesia del apéndice cecal. Informe de un caso
Cir Cir 2009; 77 (5)

Language: Español
References: 8
Page: 407-410
PDF: 103.76 Kb.

[Full text - PDF]

ABSTRACT

Background: Agenesis of the vermiform appendix is very rare and was first described by Morgagni in 1718. The estimated incidence is 1/100,000 laparotomies performed for suspected appendicitis. This case is reported with the aim of attracting the attention of surgeons who may be in a similar situation during laparotomy.
Clinical case: A 48-year-old male was admitted through the emergency room with the complaint of vague abdominal pain most marked in the epigastrium and mesogastrium which, 4 h after it began, was located in the right iliac fossa and was accompanied by hyporexia, nausea, vomiting and fever. During physical examination, the patient was febrile, tachycardic, and tachypneic, with decreased peristalsis, abdomen painful to palpation and percussion in the right iliac fossa. There were positive appendicular signs. Blood panel showed leukocytosis (14,000), neutrophilia (89.60%) and lymphopenia (5.33%). Radiographs of the abdomen showed no abnormalities. We made a presumptive diagnosis of acute appendicitis and the patient underwent celioscopy where surgical findings were reported as type IV Collins appendiceal agenesis and concomitant mesenteric adenitis.
Conclusions: Several criteria must be determined before the surgeon can conclude that the appendix is congenitally absent. Diagnosis should not be confirmed until the ileo- and retrocecal regions have been explored.


Key words: Agenesis, celioscopy, vermiform appendix.


REFERENCES

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  2. Greenberg, SL, Eyers A, MacKay S. Congenital absence of the vermiform appendix. ANZ J Surg 2003;73:166-167.

  3. Misro AK, V Radhika V. A case of congenital absence/rudimentary vermiform appendix. Bombay Hosp J 2008;50:293-294.

  4. Cserni T, Magyar A, Németh T, Paran TS, Csízy I, Józsa T. Atresia of the ileocecal junction with agenesis of the ileocecal valve and vermiform appendix: report of a case. Surg Today 2006;36:1126-1128

  5. Lima M, Antonellini C, Aquino A, Dòmini M, Libri M, Centonze N, et al. Agenesis of the appendix vermiformis. Ped Med Chir 2003;25:370-372.

  6. Collins DC. A study of 50,000 specimens of the human vermiform appendix. Am J Surg 1974;127:704-707.

  7. Collins DC. Agenesis of the vermiform appendix. Am J Surg 1951;82:689-696.

  8. Schumpelick V, Dreuw B, Ophoff K, Prescher A. Appendix and cecum embryology, anatomy and surgical applications. Surg Clin North Am 2000;80:295-318.






>Journals >Cirugía y Cirujanos >Year 2009, Issue 5
 

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