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Localization of Appendix with MDCT and Influence of Findings on Choice of Appendectomy Incision

Aytekin Oto1, Randy D. Ernst1, William J. Mileski2, Thomas K. Nishino1, Ot Le1, Gregory C. Wolfe1 and Gregory Chaljub1

1 Department of Radiology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0709.
2 Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555-0709.


Figure 1
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  		Fig. 1A —64-year-old woman with normal appendix. Three-dimensional reconstruction of abdominopelvic CT scan according to surface shaded display algorithm. McBurney's line courses from umbilicus to anterior superior iliac spine. McBurney's point (arrow) is marked. Location of appendix (A) is far below McBurney's point in this patient. Surgeon would alter incision for appendectomy.

 

Figure 2
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  		Fig. 1B —64-year-old woman with normal appendix. Axial CT scan shows base (arrowhead) of appendix.

 

Figure 3
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  		Fig. 2 —Scatterplot of superoinferior (SI) and mediolateral (ML) displacement of each patient's appendix relative to McBurney's point (located at origin). Inner and outer circles represent fixed radius of 30- and 50-mm deviation from McBurney's point, respectively. Many appendixes deviated well beyond 50 mm from McBurney's point.

 

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