Aytekin Oto MD, Abstract Co-Author: Nothing to Disclose

Ott Le MD, Presenter: Nothing to Disclose

Randy Devereux Ernst MD, Abstract Co-Author: Nothing to Disclose

William Mileski MD, Abstract Co-Author: Nothing to Disclose

Gregory W Wolfe, Abstract Co-Author: Nothing to Disclose

Thomas K. Nishino PhD, Abstract Co-Author: Nothing to Disclose

Raleigh F. Johnson PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To demonstrate the relationship between Mc Burney`s point and the appendix in normal patients by using 3D MDCT and to investigate the effect of this information on a surgeon`s choice of appendectomy incision.

One hundred adult patients (35 female and 65 male, mean age 52.1) with an identifiable appendix on their abdominopelvic MDCT examinations were selected for the study group out of 142 consecutive MDCT studies. The presence of intraabdominal mass or a history of abdominal surgery were the criteria used for exclusion. 3D reconstruction of the CT data using shaded surface display algorhtym was performed on a GE Advantage 4.1 workstation. The location of the base of appendix and Mc Burney`s point was marked on a single 3D image allowing the display of the skin surface markings for each patient. Superoinferior (SI) and mediolateral (ML) distance from the level of the appendix to the level of the Mc Burney`s point was measured. 3D CT images were also reviewed by an experienced trauma surgeon and his choice of incision for each patient based on the CT information was recorded.

The appendix was exactly at Mc Burney`s point in only 4% of the patients. Appendix was within 3.0 cm and 5.0 cm of the Mc Burney`s point in 36% and 64% of the patients, respectively. Mean SI and ML distance of the appendix from Mc Burney`s point were 33.0 mm with a standard deviation of 24.1 mm and 20.8 mm with a standard deviation of 19.3 mm, respectively. After reviewing the 3D images, the surgeon would alter his incision site in 35% of the cases. The surgeon preferred a more superior incision in 28 %, and a more inferior incision in 7 % of the cases.

The location of appendix demonstrates wide individual variability and the limitations of Mc Burney`s point as an anatomical landmark should be recognized. 3D MDCT can provide useful information enabling the surgeon to customize his appendectomy incision individually. Additional information about the location of appendix in the CT report (if possible together with a 3D image showing its location) may be beneficial in patients who will undergo appendectomy.

Oto, A, Le, O, Ernst, R, Mileski, W, Wolfe, G, Nishino, T, Johnson, R, et al, , 3D Localization of Appendix by MDCT and Its Impact on a Surgeon's Choice of Appendectomy Incision.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4407151.html