Diagnostic and Interventional Radiology
Abdominal Imaging - Original Article

“Surface map”” of the appendix: a novel tool for the preoperative demonstration of appendicular location with reference to McBurney’s point using a multidetector CT

1.

Division of Body Imaging, Diwanchand Imaging Research Center, New Delhi, India

Diagn Interv Radiol 2012; 18: 582-586
DOI: 10.4261/1305-3825.DIR.5784-12.1
Read: 612 Downloads: 352 Published: 03 September 2019

Abstract

PURPOSE 
In this study, we evaluated the role and relevance of multidetector computed tomography (MDCT) “surface map” of the appendix in demonstrating the variations in the location of the appendicular base with reference to McBurney’s point and its likely clinical implications during an open appendicectomy. 

 

MATERIALS AND METHODS 
This prospective study included a total of 74 patients who underwent an MDCT study of the abdomen for various clinical indications. Post-processing of the data was performed and a “surface map” of the appendicular base was reconstructed with a superimposed measurement grid. The variation in the appendicular base location with reference to McBurney’s point was analyzed along the cranio-caudal and medio-lateral axes. 

 

RESULTS 
The maximum deviation in the location of the appendicular base was +10.0 cm along the cranio-caudal axis and -4.2 cm along the medio-lateral axis. The average cranio-caudal deviation was +2.79 cm, while the average medio-lateral deviation was +0.146 cm. In the subgroup of 16 patients who had appendicular inflammation, the maximum deviation was +8.8 cm along the cranio-caudal axis and +3.0 cm along the medio-lateral axis. The average cranio-caudal deviation in this subgroup of patients was +2.77 cm; the average medio-lateral deviation was +0.77 cm. 

 

CONCLUSION 
The MDCT “surface map” of the appendix is an effective tool that can convey precise information regarding appendix location to the operating surgeon. There are significant variations in the location of the appendicular base with reference to McBurney’s point. These variations are more pronounced along the cranio-caudal axis than the medio-lateral axis. Accurate preoperative localization of the appendicular base with MDCT will help surgeons optimize the initial incision for an open appendicectomy, thus, minimize extension-related incision risks.

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