New nomenclature of McBurney's points according to of old and recent anatomical and clinical publications

Abstract Abstract Background: McBurney's point is traditionally considered as the main clinical landmark for the diagnosis of acute appendicitis. However, several anatomical and radiological studies have shown that the surface projection of the appendiceal base is highly variable, calling into question the anatomical validity of this landmark. This controversy led our team to conduct new anatomical and clinical research on this important issue. Objective: To raise awareness among anatomists and surgeons about the lack of consensus regarding the location of McBurney's points and to make our proposal for a more descriptive anatomical nomenclature for these points more widely known. Methods: A narrative review of the literature was conducted using biomedical databases and scientific search engines. Historical, anatomical, radiological and clinical studies concerning McBurney's points, the umbilicospinal line and the anatomical projection of the appendiceal base were selected and analyzed. Results: Radiological studies by Karim et al. and Naraynsingh et al. showed that, in the majority of cases, the appendiceal base does not project onto the classically described McBurney's point. Duque proposed incorporating the umbilicospinal line into anatomical nomenclature. Our anatomical and clinical studies confirmed the value of this line as an anatomical and clinical landmark, with the projection of the appendiceal base and the location of elicited pain in uncomplicated appendicitis most often occurring along this line. Conclusion: Available data indicate that the umbilicospinal line is a more relevant anatomical and clinical landmark than McBurney's point for describing the ileocecal-appendiceal region. We propose its incorporation into the Terminologia Anatomica under the term linea ombilicospinalis, together with the adoption of the terms punctum ombilicospinalis medium and punctum ombilicospinalis lateralis to improve anatomical precision and international terminological harmonization. Keywords: Vermiform appendix, McBurney, linea ombilicospinalis, punctum ombilicospinalis medium, punctum ombilicospinalis lateralis