The presence and the anatomical variations of the accessory appendicular artery: A systematic review of 604 cases

Author:

Savvakis Stavros1,Karamitsou Paraskevi2,Vardaxi Chrysoula2,Forozidou Evropi2,Emfietzis Panagiotis‐Konstantinos1,Mantsopoulos Konstantinos3,Anastasopoulos Athanasios1,Poutoglidis Alexandros1ORCID

Affiliation:

1. Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Medical School Aristotle University of Thessaloniki Thessaloniki Greece

2. Department of Otorhinolaryngology‐Head and Neck Surgery “G. Papanikolaou” General Hospital Thessaloniki Greece

3. Department of Otorhinolaryngology, Head and Neck Surgery Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Erlangen Germany

Abstract

AbstractIntroductionThe accessory appendicular artery (AAA) is an accessory source of blood supply to the appendix. Its existence and potential point of origin are seldom addressed in the literature.MethodsTo fill this knowledge gap, we performed a systematic review of all available studies involving both cadaveric and surgical specimens and documented the presence and the origin of the AAA, following the guidelines outlined in the preferred reporting items for systematic reviews and meta‐analysis (PRISMA) statement.ResultsEleven studies, with an overall of 604 specimens were included. Our research revealed that the AAA is notably absent in most cases (83.6%). When present, it most commonly originates from the posterior cecal artery (12.4%), followed by the descending branch of the ileocolic artery (2%), and the ileal branch of the ileocolic artery (0.7%). Instances of origin from the anterior cecal, common cecal, or the ileocolic trunk were even more infrequent. Based on our observations, we introduced a new simplified classification system.DiscussionThe effect of an accessory artery on the process of appendicitis remains to be clarified. We firmly recommend that surgeons should consider the possible presence and various origins of the AAA during appendectomy procedures to avoid serious complications.

Publisher

Wiley

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