Acute single appendicitis in a female with a duplicated appendix

Abstract

Appendiceal duplication is a rare congenital anomaly with an estimated incidence ranging from 0.004 to 0.009%. Preoperative diagnosis of a duplicated appendix is often difficult and is usually done intraoperatively. Histopathological examination of the surgical specimen is mandatory to confirm the presence of two appendices. In this case we report a female patient with acute inflammation in one of her two appendices. Surgeons should always bear in mind this rare anomaly to avoid serious ethical and legal consequences.

Figure 1:

A photograph taken during surgery. Blue arrow indicates the site of inflamed appendix after resection. Green arrow indicates the second appendix.

Figure 2:

Microscopic view of the first specimen with acute appendicitis. Sections show focal ulceration of the mucosa and acute inflammatory infiltrate (mainly neutrophils) throughout the wall.

Figure 3:

Microscopic view of the second specimen with a nearly normal appendix. Sections show a thin walled appendix lined by a colonic type glandular epithelium.