Introduction:The vermiform appendix is a vestigial structure showing extreme variability in its position. Varying symptoms of acute appendicitis reflect this variability making the clinical presentation of appendicitis highly inconsistent. Objective: To observe the anatomical variations of the position of the tip of the appendix and its base, length, details of meso-appendix and appendicular artery in adult medico-legal autopsies. Methods: A sample of medico legal autopsies carried out on those over 18 years by forensic pathologists at the Teaching Hospital Peradeniya was included in this study. Results: Of the 60 autopsies, 39 were male, with an age range of 19-88 years. Fifty eight appendixes were healthy, 1 appendicular mass and 1 absent appendix. Positions of the appendices were: 29 (50%) post-ileal, 20 (34.48%) retro-caecal, 7 (12.07%) pelvic and 2 (3.45%) para-caecal. The base was at the postero-medial wall in 36 (62.07%), lower pole in 18 (31.03%) and postero-lateral wall of the ceacum in 4 (6.0%) subjects. The length was 3cm -14 cm (mean 8.2 cm). The distance between ileo-caecal valve and base of the appendix was 1 cm -6 cm (mean 2.8 cm). The distance between the edge of the meso-appendix and the tip was 0 cm -7 cm (mean 1.23 cm). In 51.7 % of cases meso-appendix continued to the tip. The appendicular artery continued to the tip in 37 (63.8%) cases. Conclusions: Post ileal position is the commonest position of the appendix, with the base situated commonly on the postero-medial wall of the caecum. In the majority of cases mesoappendix and the appendicular artery continued to the tip.
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