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Case Reports
. 2015 Apr;100(4):662-5.
doi: 10.9738/INTSURG-D-14-00150.1.

Duplicate appendix with acute ruptured appendicitis: a case report

Sharique Nazir  1 , Alex Bulanov, Mohammed Iyoob Mohammed Ilyas, Ibrahim I Jabbour, Larry Griffith
Affiliations
Case Reports

Duplicate appendix with acute ruptured appendicitis: a case report

Sharique Nazir et al. Int Surg. 2015 Apr.

Abstract

Duplication of the appendix is a rare congenital anomaly that, in adults, is most often found incidentally during surgery for other reasons. Appendicitis in the duplicated appendix is very rare and has been reported less than 10 times in the medical literature. We describe a 33-year-old woman with worsening periumbilical pain, nausea, vomiting, and fever. Physical examination showed localized peritonitis in the right lower quadrant. She had an elevated white blood cell count with neutrophilia. Computed tomography showed acute ruptured appendicitis. Diagnostic laparoscopy showed 2 appendices attached via separate bases to a single cecum with no other concurrent anomalies. Both appendices were removed laparoscopically. Histopathology confirmed normal appendiceal tissue in one and severe acute transmural appendicitis in the other. Awareness of appendiceal duplication and a thorough intraoperative inspection are critical to assess the presence of significant associated anomalies and avoid life-threatening complications.

Keywords: Acute abdomen; Appendiceal duplication; Cave-Wallbridge classification; Ruptured appendicitis.

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Figures

Fig. 1
Fig. 1
Normal appearing appendix (specimen A on top); inflamed appendix with congested surface, fibrinopurulent exudate on serosa, and prominent vessels (specimen B on bottom).
Fig. 2
Fig. 2
Histologic sections of appendices. (Left) Specimen A normal appendicular tissue. (Right) Specimen B severe acute transmural appendicitis.
See this image and copyright information in PMC

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