Nayak Satheesha B, George Bincy Muthukattu, Mishra Snigdha, Surendran Sudarshan, Shetty Prakashchandra, Shetty Surekha Devadasa
Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India.
Anat Cell Biol. 2013 Dec;46(4):296-8. doi: 10.5115/acb.2013.46.4.296. Epub 2013 Dec 24.
The subhepatic position of the cecum and appendix is a result of embryological reasons. Subhepatic appendicitis can cause diagnostic dilemmas. During the dissection of an adult male cadaver aged approximately 70 years, the subhepatic position of the cecum and appendix was noted. The appendix made a "U"-shaped bend and its tip was located in the paracolic position. The cecum had appendices epiploicae, and the terminal part of the ileum was retroperitoneal and had ascended vertically to the cecum from the right iliac fossa. Functionally, the sessile part of the ileum might restrict its peristaltic movements. The abnormal position of the terminal ileum might be mistaken for an ascending colon during laparoscopic surgery. The subhepatic position of the cecum and appendix might cause confusion in the diagnosis of acute appendicitis because the tenderness in such cases is not located at the McBurney's point.
盲肠和阑尾的肝下位置是胚胎学原因导致的。肝下阑尾炎可导致诊断困境。在解剖一名约70岁的成年男性尸体时，发现了盲肠和阑尾的肝下位置。阑尾呈“U”形弯曲，其尖端位于结肠旁位置。盲肠有网膜阑尾，回肠末端位于腹膜后，从右髂窝垂直向上至盲肠。在功能上，回肠的无蒂部分可能会限制其蠕动。在腹腔镜手术中，回肠末端的异常位置可能会被误认为是升结肠。盲肠和阑尾的肝下位置可能会在急性阑尾炎的诊断中造成混淆，因为这种情况下的压痛并不位于麦氏点。
