Usman Ali, Mohammad Siyar, Wajid Akbar.
Variation in Signs & Symptoms of Acute Appendicitis in Relation to Associated Positions.
Ophthalmol Update Jan ;15(3):299-302.

Background: Vermiform Appendix can be present in various positions in relation to caecum. Classical signs and symptoms of acute appendicitis may differ due to various positions of appendix. Objective: The objective of this study is to know how appendicitis presents in different positions, and its impact on complications. Material and methods: This study was conducted in surgical `A` Unit, Mardan Medical Complex from January 2012 to March 2014. The designed of the study was descriptive type. Patients coming to emergency ward were examined after detailed history, investigation and operated. Position of appendix along with other findings were noted. Results: Patients presenting as acute appendicitis were admitted(100). 68% were male and 32% were female. During surgery the position of appendix was recorded. Retrocaecal position was the most common (78%) cases followed by pelvic position in 16% cases. Perforated appendix was observed in 3 patients (all retrocaecal appendix). Conclusion: Retrocaecal appendix was the commonest position of Appendix (78%).The signs and symptoms of acute appendicitis in retrocaecal position are disproportionally less severe. Some of those patients suffering from signs and symptoms of mild to moderate severity may be having perforated /gangrenous Appendix.

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