Unusually Long Pre-Ileal Vermiform Appendix Presenting as Acute Appendicitis in a Young Female: A Rare Anatomical Variant with Diagnostic Implications

Author(s)	Dr. ITISHREE JENA, Dr. Ratnesh Kumar
Country	India
Abstract	Background: The vermiform appendix exhibits substantial variation in length and orientation. While the average length is 6–9 cm, extreme elongation is uncommon in living patients and may present with atypical symptoms in young females. Case: We report a 22-year-old female presenting with right iliac fossa pain, abdominal distension, and low-grade fever. Ultrasonography suggested appendicitis, but gynecologic differentials were initially considered. Open appendectomy revealed an unusually long 17.2-cm pre-ileal appendix, markedly inflamed throughout its course. Histopathology confirmed acute suppurative appendicitis. Recovery was uneventful. Conclusion: Elongated appendices may mimic gynecologic disorders and pose intraoperative challenges. Surgeons must recognize such anatomical variations to prevent incomplete removal and stump appendicitis.
Keywords	Keywords: Appendix; Anatomical variation; Acute appendicitis; Long appendix; Pre-ileal appendix; Young female
Published In	Volume 8, Issue 1, January-February 2026
Published On	2026-02-21
DOI	https://doi.org/10.36948/ijfmr.2026.v08i01.69582

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