ANATOMICAL VARIATIONS OF THE APPENDIX AND THEIR IMPACT ON DIAGNOSTIC IMAGING AND SURGICAL APPROACH

Background: This study aimed to determine the frequency of different anatomical positions of the appendix and evaluate their impact on imaging accuracy, operative difficulty, and postoperative outcomes. Methods: A cross-sectional study was conducted at the Department of Surgery, Bannu Medical College, Bannu, from January 2024 to January 2025. Seventy-two patients undergoing appendectomy for suspected acute appendicitis were enrolled through consecutive sampling. Demographic data, clinical presentation, imaging findings, and intraoperative observations regarding appendix position and length were recorded. Operative time, conversion rates, and postoperative complications were documented. Statistical analysis was performed using SPSS version 26, with p<0.05 considered significant. Results: The mean age of patients was 26.8 ± 8.4 years, with a slight male predominance (55.6%). Retrocecal position was the most frequent anatomical variant (41.7%), followed by pelvic (25%) and subcecal (13.9%). Ultrasound correctly identified appendix position in 80.6% of cases, with lower sensitivity for retrocecal appendices (p=0.02). Mean operative time was significantly longer for retrocecal appendices (p=0.04), but complication rates and hospital stay showed no statistically significant difference. Conclusion: Anatomical variation of the appendix, particularly the retrocecal type, affects preoperative imaging accuracy and increases operative time but does not significantly influence postoperative morbidity. Awareness of these variations and appropriate imaging can enhance diagnostic accuracy and optimize surgical planning.