Development of the vermiform appendix in children from different age ranges
J. Morphol. Sci., vol.26, n2, p.0, 2009
There is no precise anatomical trace that limits the vermiform appendix of the cecum in the newborn and in the child in the first years of life. The appendix presents a conical form, with an enlarged base and a narrow apex. The objective of the present work was to identify certain anatomical parameters, and to relate them chronologically to the different age groups in order to define when exactly the base of implantation of this organ in the cecum resembles the adult’s anatomy. Sixty-seven (67) ileocecal transition pieces were grouped according to the different age groups: Group A (18 pieces of newborns at term) – Group B (14 pieces of six months-old children) – Group C (13 pieces of 12 month-old children) – Group D (11 pieces of 24 month-old children) and Group E (11 pieces of adults). The point of contact of the ileum anti-mesenteric edge in the cecum was identified and the distance between this and the edges, right (d.r.e.i) and left (d.l.e.i.), of the appendix implantation was assessed. The results were demonstrated through the crossing of variables in the different age groups and the statistical significance level was considered for p < 0.05. From the sixty-seven (67) pieces, forty-seven (70.1%) were obtained from males and twenty (29.9%) from females. The average extension of the vermiform appendix length was 5.3 cm. The retro ileum position was predominant in the first year of life (groups A, B and C). The average of the variables according to the age group (groups A, B, C, D and E) was: D.L.E.I. = 0.0-0.0-0.5-2.0-2.5 cm respectively. D.R.E.I. = 1.1-1.0-1.3-2.3-2.8 cm respectively. DIAMETER of the BASE = 1.0-0.8-0.4-0.3-0.5 cm respectively. The crossing of the average values of the distances from the left margin of the appendix base to the ileum (d.l.e.i.) was performed in groups A, B, C and D with the average value in group E (adult). Differences between these variables are statistically significant with p = 0.00 for groups A, B and C and p = 0.003 for group D, refuting the null hypothesis and confirming the alternative hypothesis. When the distance from the right margin of the appendix base to the ileum (d.r.e.i.) between groups A, B, C, D and group E is analyzed, the results also seemed to be statistically significant with p = 0.00 and p = 0.004 respectively. It was concluded that the development of the left margin of the vermiform appendix implantation to the ileum is considered as the most important anatomical parameter as much to the utmost acquisition of the form of the organ (narrow base), similar to that found in the adult individuals, as to the definition of the anatomical transition between the cecum and the vermiform appendix.
vermiform appendix, cecum-appendicular region, appendicitis, in children