{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:08:56Z","timestamp":1788455336197,"version":"build-2803163510"},"reference-count":72,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T00:00:00Z","timestamp":1570838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Determining the true and indisputable data regarding the vermiform appendix (VA) morphology is of a great clinical interest. The aim of this study was to provide the best evidence\u2010based anatomical overview of the variations in location and size of VA using a systematic and meta\u2010analytical approach. A systematic review with meta\u2010analysis was performed of studies reporting variants of the location and morphometric data regarding the VA. The MEDLINE\/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science databases were thoroughly searched throughout June 2018. The reported locations of the body of the VA were re\u2010classified into a new, standardized classification system divided into nine categories. The AQUA tool was used to assess the quality of included studies. The research was conducted following PRISMA guidelines and registered at PROPSERO database. Our meta\u2010analysis included 242 studies (<jats:italic>n<\/jats:italic> = 114,080). Overall, the VA was most commonly found in the retrocecal location (32.1%, 95%CI: 29.2\u201335.1), followed by the pelvic (28.5%, 95%CI: 26.7\u201330.4) and ileal (14.5%, 95%CI: 11.8\u201317.7) locations. Subjects without known appendiceal pathologies had significantly smaller VA outer diameters (5.84\u2009mm, 95%CI: 5.68\u20135.99) than patients diagnosed with acute appendicitis (10.64\u2009mm, 95%CI: 10.14\u201311.15). The overall pooled mean length of the VA was 80.29\u2009mm (95%CI: 76.68\u201383.89). Significant differences were found in size of the VA between imaging modalities. The results obtained from this evidence\u2010based anatomy study will improve the clinical understanding of the VA anatomy, which in turn will have major implications for clinical practice. Clin. Anat. 32:85\u201398, 2019. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.23474","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T01:13:01Z","timestamp":1569978781000},"page":"85-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Variations and morphometric features of the vermiform appendix: A systematic review and meta\u2010analysis of 114,080 subjects with clinical implications"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9447-173X","authenticated-orcid":false,"given":"Artur","family":"Kacprzyk","sequence":"first","affiliation":[{"name":"Jagiellonian University Medical College  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Dro\u015a","sequence":"additional","affiliation":[{"name":"Jagiellonian University Medical College  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Stefura","sequence":"additional","affiliation":[{"name":"Jagiellonian University Medical College  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Krzysztofik","sequence":"additional","affiliation":[{"name":"Jagiellonian University Medical College  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Jasi\u0143ska","sequence":"additional","affiliation":[{"name":"School of Medicine in English, Jagiellonian University Medical College  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"P\u0118dziwiatr","sequence":"additional","affiliation":[{"name":"2<sup>nd<\/sup> Department of General Surgery Jagiellonian University Medical College  Cracow Poland"},{"name":"Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery)  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Major","sequence":"additional","affiliation":[{"name":"2<sup>nd<\/sup> Department of General Surgery Jagiellonian University Medical College  Cracow Poland"},{"name":"Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery)  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5754-594X","authenticated-orcid":false,"given":"Mateusz","family":"K. Ho\u0142da","sequence":"additional","affiliation":[{"name":"Department of Anatomy Jagiellonian University Medical College  Cracow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.30265"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12470"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006565-200110000-00004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.06.089"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1703"},{"key":"e_1_2_6_7_1","first-page":"338","article-title":"Anomalies of the vermiform appendix and prevalence of acute appendicitis in Khartoum","volume":"76","author":"Bakheit MA","year":"1999","journal-title":"East Afr Med J"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22269"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2014.04.009"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-011-0977-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2007.11680076"},{"key":"e_1_2_6_12_1","first-page":"49","article-title":"Morphometric variants of the cecal appendix in a living person","volume":"36","author":"Casado M\u00e9ndez PR","year":"2014","journal-title":"Rev M\u00e9dica Electr\u00f3nica"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2015.05.019"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-014-1206-4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-016-0090-5"},{"key":"e_1_2_6_16_1","first-page":"20","article-title":"The first experience in laparoscopic appendectomy in children","volume":"4","author":"Dronov AF","year":"1994","journal-title":"Khirurgiia (Sofiia)"},{"key":"e_1_2_6_17_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.4103\/1117-1936.181412","article-title":"Acute appendicitis in Lagos: A review of 250 cases","volume":"16","author":"Fashina IB","year":"2009","journal-title":"Niger Postgr Med J"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002188"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2955"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-016-1430-3"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2017-221198"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2018.0190"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20587"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aanat.2015.12.002"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22799"},{"key":"e_1_2_6_26_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JPT","year":"2011"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.21601\/ortadogutipdergisi.267262"},{"key":"e_1_2_6_28_1","first-page":"352","article-title":"Comparison between predicted position of appendix on clinical examination and position of appendix as an intraoperative finding in patients with clinically suspected acute appendicitis","volume":"25","author":"Iqbal Z","year":"2011","journal-title":"J Postgrad Med Inst"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.rct.0000164668.03767.53"},{"key":"e_1_2_6_30_1","first-page":"61","article-title":"Clinical picture and diagnosis of appendicitis in atypical localization of the vermiform process","volume":"6","author":"Kanamatov IK","year":"1980","journal-title":"Khirurgiia (Mosk)"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1366074"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.08.021"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.rct.0000228151.73528.8f"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.15226\/2374-815X\/2\/2\/00134"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12821"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2017.0028"},{"key":"e_1_2_6_37_1","first-page":"10","article-title":"Original article a pre\u2010operative and post\u2010operative comparative analysis of different anatomical position, clinical presentation and USG findings of appendix in patients of appendicitis in a tertiary care teaching hospital","volume":"1","author":"Kumar K","year":"2015","journal-title":"Int J Med Res Prof"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2011.04.003"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.07.025"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.3348\/jksr.2014.70.4.283"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481608201036"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2017.11.020"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02774803"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_6_45_1","first-page":"310","article-title":"Laparoscopy in complicated pediatric appendicitis","volume":"8","author":"Moraitis D","year":"2004","journal-title":"JSLS J Soc Laparoendosc Surg"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/871048"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1286-0115(05)83239-4"},{"key":"e_1_2_6_48_1","first-page":"198","article-title":"The position of the vermiform appendix in Nigerians with a review of the literature","volume":"8","author":"Ojeifo JO","year":"1989","journal-title":"West Afr J Med"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.3576"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.5455\/2320-6012.ijrms20131107"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-013-2948-1"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2261011612"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-003-2077-3"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-018-0179-0"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(05)70407-2"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.02.035"},{"key":"e_1_2_6_57_1","first-page":"48","article-title":"Morphometric study of human cadaveric caecum and vermiform appendix","volume":"3","author":"Setty SNRS","year":"2013","journal-title":"Int J Heal Sci Res"},{"key":"e_1_2_6_58_1","first-page":"1176","article-title":"A prospective comparative analysis of clinical presentation and USG findings of appendix in patients of appendicitis in Saharsa, Bihar","volume":"8","author":"Sinha RN","year":"2013","journal-title":"Indian J Basic Appl Med Res"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.18410\/jebmh\/2014\/89"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.18410\/jebmh\/2017\/276"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-002-6457-7"},{"key":"e_1_2_6_62_1","unstructured":"ThyagarajJ.2005. Study of the Anatomical Position of the Appendix in Normal Population and in Inflamed Cases. URL:http:\/\/52.172.27.147:8080\/jspui\/handle\/123456789\/1037?mode=full[accessed Jan 25 2019]."},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2012.01.028"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.5847\/wjem.j.1920-8642.2016.02.007"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-009-1706-x"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.01.027"},{"key":"e_1_2_6_67_1","first-page":"262","article-title":"Anatomical variations of caecum and appendix: A cadveric study in Mysore based population","volume":"3","author":"Vidya C","year":"2016","journal-title":"Indian J Clin Anat Physiol"},{"key":"e_1_2_6_68_1","first-page":"277","article-title":"The position of the vermiform appendix as ascertained by an analysis of 10,000 cases","volume":"67","author":"Wakeley CP","year":"1933","journal-title":"J Anat"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0096476"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2007.26.1.37"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v6.i12.913"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9941.107128"},{"key":"e_1_2_6_73_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i31.10938"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23474","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.23474","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:16:11Z","timestamp":1693354571000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.23474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,12]]},"references-count":72,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/ca.23474"],"URL":"https:\/\/doi.org\/10.1002\/ca.23474","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,12]]},"assertion":[{"value":"2019-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}