The vermiform appendix is a narrow, worm-like tube, usually about 6-10 cm long, opening from the posteromedial wall of the caecum. Its base is fixed where the taeniae coli meet, but its tip can lie in several positions, most commonly behind the caecum (retrocaecal) or hanging into the pelvis. Its wall is rich in lymphoid tissue, and it is suspended by a small mesentery, the mesoappendix.
| Location | Right iliac fossa, arising from the posteromedial caecum; tip position variable (retrocaecal, pelvic, subcaecal, pre-ileal or post-ileal) |
|---|---|
| Parts |
|
| Nerve Supply | Superior mesenteric plexus (sympathetic, referred to T10 dermatome); Vagus nerve (parasympathetic) |
| Blood Supply | Appendicular artery (from the ileocolic artery) |
| Venous drainage |
|
| Lymphatic drainage |
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Contains gut-associated lymphoid tissue that contributes to mucosal immunity and may serve as a reservoir for beneficial gut bacteria.
The base of the appendix lies under McBurney point, one-third of the way from the right anterior superior iliac spine to the umbilicus. Pain of appendicitis typically starts around the umbilicus (visceral T10) and then moves to the right iliac fossa as the parietal peritoneum is irritated. The appendicular artery is an end artery, so inflammation can quickly lead to gangrene and perforation.
Inflammation of the appendix, usually from luminal obstruction, causing migrating abdominal pain, fever and tenderness in the right iliac fossa.
Usually small, slow-growing tumour often found incidentally after appendicectomy.
Mucin-producing tumour of the appendix that can rupture and spread mucin through the peritoneum (pseudomyxoma peritonei).
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