OBJECTIVE: To study whether the different positions of appendix can affect its susceptibility to acute inflammation. DESIGN: Prospective study. SETTING: Surgical Unit III, Bahawal Victoria Hospital, Bahawalpur. PERIOD: 01.02.2000 to 30.10.2000. SUBJECTS & METHODS: 281 cases of acute appendicitis admitted and operated were studied. Position and condition of appendix were noted including inflamed/highly inflamed and normal. The incidence of hematuria/pyuria was also noted. RESULTS: The retrocaecal position was the c( mmonest (79%) followed by pelvic position (14%). Out of 223 cases of retrocaecal appendix, only (7%; were normal whereas (21%) normal appendices were found in other than retrocaecal position. Advanced appendicitis was more common in retrocaecal position (22%, p-value <0.001) as compared to other positions (10%). There was a considerable overlap between the findings of advanced appendicitis & hematuria/Pyuria, especially in retrocecal position (13%). CONCLUSION: The different positions of appendix present as the variety of signs & symptoms in acute appendicitis. Retrocecal appendix, in addition to making the diagnosis of acute appendicitis more difficult, is also more prone to infection, perforation and gangrene.
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