CONGENITAL absence of the vermiform appendix is a rare condition in man that too many well-experienced surgeons have never seen. Collins1 found one case in 104,066.
The fact that congenital absence of the vermiform appendix has been reported on several occasions confirms its existence and should be kept in mind. A thorough and meticulous search of the entire ileocecal region and mobilization of the cecum and ascending colon should be carried out before the diagnosis is made.
The length of the appendix is usually between 8 to 10 cm with extremes being 2 to 25 cm. But, it should also be kept in mind that early cessation of appendiceal anlage can result in very tiny ones. Bryant's2 6 mm specimen and Huntingdon's3 5 mm might be overlooked, especially if masked by fat.
Embryology and Anatomy
A fully developed appendix is seen in a 10-week-old embryo. The appendix
Elias EG, Hults R. Congenital Absence of Vermiform Appendix. Arch Surg. 1967;95(2):257-258. doi:10.1001/archsurg.1967.01330140095022