A different view of the sonographic classification of the appendix

Mikail İnal; Birsen Ünal Daphan; M. Yasemin Karadeniz Bilgili

doi:10.21601/ortadogutipdergisi.267262

ORTADOĞU TIP DERGİSİ - ORTADOGU MEDICAL JOURNAL

A different view of the sonographic classification of the appendix

Apendiksin ultrasonografik sınıflamasına farklı bir bakış açısı

Mikail İnal ¹ ^* , Birsen Ünal Daphan ¹, M. Yasemin Karadeniz Bilgili ¹

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Ortadogu Tıp Derg, Volume 8, Issue 4, pp. 207-213

https://doi.org/10.21601/ortadogutipdergisi.267262

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Abstract

Aim: We intended to detect various appendix localisations with a classification system different from those used in previous literature to facilitate the sonographic detection of the appendix.
Patients and methods: The study was performed on 362 consecutive patients who applied to our department for abdominal or pelvic US examination to our department. The sonographic criterion used to diagnose a normal appendix was visualization of the full extension of a compressible, blind-ending tubular structure with a maximum transverse diameter of 6 mm. Appendices were evaluated by US and localisations were recorded and classified according to the reference line passing through the iliac vessels in the right iliac fossa.
Results: Each appendix was classified as type 1 to 8 according to its location. Type 1 crossed the iliac vessels (85.5%), type 2 was medial to the iliac vessels (2.41%), type 3 was inferior and lateral to the cecum (1.93%), type 4 was in the right paracolic gutter (4.34%), type 5 was completely retrocecal (1.93%), type 6 was in front of the cecum (1.45%), type 7 extended to the umbilicus (0.97%) and type 8 was subhepatic with cecal malposition (1.45%).
Conclusion: The study demonstrated a new classification system (types 1–8) different from those described in previous literature. The most common position of the normal and abnormal appendices in our study was crossing the iliac vessels (type 1). The second most common position was the right paracolic gutter (type 4). Two interesting localisations extended to the umbilicus (type 7) and appeared in the subhepatic space (type 8).

Keywords: Appendicitis, normal appendix, cecum-appendicular region, abdomen, sonography.

Öz

Amaç: : Biz bu çalışmada farklı lokalizasyonlardaki apendiksleri inceleyerek önceki literatürden farklı bir sınıflama yapmayı ve böylece appendiksin sonografik incelemesini kolaylaştırmayı amaçladık.
Materyal ve metod: Çalışma bizim departmanımıza pelvik veya batın ultrasonografisi amacı ile başvuran 362 ardışık hasta üzerinde gerçekleştirildi. Normal sonografik apendiks kriterleri maksimum çapı 6 mm olan, komprese olan, kör sonlanan tübüler yapı olarak belirlendi. Appendiksler ultrasonografi ile incelendi ve kaydedildi, referans çizgisi olarak da sağ iliak fossadaki iliak damarlar alındı.
Bulgular: Apendiksler yerleşim yerine göre 1-8 sınıfa ayrıldı. Tip 1 iliak damarları geçen (85.5%),tip 2 iliak damarların hemen yanında (2.41%), tip 3 çekumun inferior ve lateralinde (1.93%), tip 4 sağ parakolik olukta (4.34%), tip 5 tamamen retroçekal (1.93%), tip 6 çekumun anteriorunda (1.45%), tip 7 umblikusa uzanan (0.97%) and tip 8 çekal malpozisyonla birlikte subhepatik yerleşim (1.45%).
Sonuç: Bu çalışmada literatürde daha önceden tanımlanandan farklı olarak yeni bir sınıflama sistemi (1-8) ortaya konulmuştur. Normal ve anormal apendikslerin en sık görülen yerleşimi iliak damarları geçen tip 1 olarak izlendi. İkinci en sık görülen yerleşim ise sağ parakolik olukta izlenen tip 4 idi. İki farklı ilginç yerleşim ise umblikusa uzanan tip 7 ile subhepatik alana uzanan tip8 idi.

Keywords: Apandisit, normal apendiks, çekum-periapendiküler bölge, abdomen, ultrasonografi.

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Citation

İnal M, Daphan BÜ, Bilgili MYK. A different view of the sonographic classification of the appendix. Ortadogu Tıp Derg. 2016;8(4):207-13. https://doi.org/10.21601/ortadogutipdergisi.267262

İnal, M., Daphan, B. Ü., & Bilgili, M. Y. K. (2016). A different view of the sonographic classification of the appendix. Ortadoğu Tıp Dergisi, 8(4), 207-213. https://doi.org/10.21601/ortadogutipdergisi.267262

İnal, M., Daphan, B. Ü., and Bilgili, M. Y. K. (2016). A different view of the sonographic classification of the appendix. Ortadoğu Tıp Dergisi, 8(4), pp. 207-213. https://doi.org/10.21601/ortadogutipdergisi.267262

İnal M, Daphan BÜ, Bilgili MYK. A different view of the sonographic classification of the appendix. Ortadogu Tıp Derg. 2016;8(4), 207-213. https://doi.org/10.21601/ortadogutipdergisi.267262

İnal, Mikail, Birsen Ünal Daphan, and M. Yasemin Karadeniz Bilgili. "A different view of the sonographic classification of the appendix". Ortadoğu Tıp Dergisi 2016 8 no. 4 (2016): 207-213. https://doi.org/10.21601/ortadogutipdergisi.267262

İnal, Mikail et al. "A different view of the sonographic classification of the appendix". Ortadoğu Tıp Dergisi, vol. 8, no. 4, 2016, pp. 207-213. https://doi.org/10.21601/ortadogutipdergisi.267262