ARRS 2022 Abstracts


E1835. Morphology of Normal Appendices on Computed Tomography
  1. Nguyen Nhi; Hue University of Medicine and Pharmacy Hospital
  2. Trong Khoan Le ; Hue University of Medicine and Pharmacy Hospital
  3. Thanh Thao Nguyen; Hue University of Medicine and Pharmacy Hospital
  4. Trong Binh Le ; Hue University of Medicine and Pharmacy Hospital
The objective of this study was to describe the morphology of normal appendices on abdominal contrast-enhanced CT (CECT) and to investigate the correlation between morphological factors and patient demographics.

Materials and Methods:
All patients over 18 years old who underwent abdominal CECT for various indications at a single institution from 5/2019 to 7/2020 were enrolled. Exclusion criteria were right lower quadrant pain, fever, colonic wall thickening, and history of appendicular disease (chronic appendicitis, appendiceal phlegmon, abscess, mucocele). Appendiceal morphology was documented on the venous phase, including maximal outer-to-outer wall diameter, wall thickness, length, intraluminal contents, and base and tip locations. Length was measured using curved multiplanar reconstruction technique. All measurements were obtained utilizing 200% magnification.

A total of 186 consecutive patients (102 men and 84 women), mean age 51.6 ± 13.4 years, met the inclusion criteria. The mean appendiceal outer-to-outer wall diameter was 6.7 ± 1.3 mm (range, 3.6–11.7 mm), mean length 82.1 ± 24.8 mm, (range, 20.5–138.2 mm), mean wall thickness 2.1 ± 0.4 mm (range, 1.1-3.2 mm). Appendiceal diameter between 6 and 10 mm was seen in 68.8% of patients, and greater than 10 mm was seen in 2.7% of patients. Among 186 appendices, 6.5% were completely collapsed, 14% completely air-filled, 8.6% completely fluid-filled. Eleven patients had appendicoliths (5.9%), of which 4 patients had 2 appendicoliths. The most common locations of the appendiceal tip were subcecal and retrocecal (45.2%); appendiceal base was postero-inferiomedial (75.8%). Appendiceal length was positively correlated with body height and negatively correlated with age, whereas diameter was positively correlated with BMI (p < 0.05).

Correlation of clinical manifestations and multiple morphological factors may be helpful when diagnosing appendicitis on CECT. Normal appendices can contain air, fluid, and appendicolith with an incidence that varies among individuals.