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Congenital Abnormalities of the Colon

This excerpt was created in the absence of an abstract.

The appendix, being a vestigial structure, is subject to many anatomical variations in its length, its lumen, its position and its mobility. The practical importance of these is in the differentiation between some of them and pathological changes.

The classical appearance of the appendix in a barium meal is that of a blind tube, 3 to 4 inches in length, 2 to 4 mm. in calibre, and showing a gentle single or double curve. From this prototype there may be marked variation. Its length may be represented by a mere thread of barium. or be 5 or 6 mm. in width. Tonicity takes some part in this, since the lumen is usually larger when filled by a barium enema. The lumen, classically uniform, may be slightly narrower towards the base. Muscular tone and peristalsis may cause inconstant constrictions, which are to be differentiated from permanent strictures. Normally there may be gaps in the filling of the appendix, which must be distinguished from the permanent filling defects of concretions.

The position of the appendix is very variable. It is most commonly found to the inner side of the cæcum, but may lie behind the cæcum or to the outer side of it, turn upwards to the liver, or hang down into the pelvis.

The junction with the cæcum is normally on the medical wall of the latter below the ileo-cæcal junction. It is to the right in situs inversus partialis, and the infantile apical point of origin may persist.

Received for publication December 14, 1936.