Article

Double appendix

British Journal of Surgery (Impact Factor: 5.21). 11/1962; 50(221):346-7. DOI: 10.1002/bjs.18005022124
Source: PubMed
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    ABSTRACT: Although the finding of appendiceal duplication is uncommon, its misdiagnosis and mismanagement may yield poor clinical outcomes and serious medicolegal consequences. Laparoscopic surgical exploration was performed on a 17-year-old male patient with right lower quadrant pain and a history of a previous appendectomy. Inspection of the cecum revealed a second appendix, which was retrocecal, ruptured, and gangrenous. Appendiceal duplication should be considered in all cases of lower abdominal pain, and careful inspection of the cecum for appendiceal anomalies should be performed. The Cave-Wallbridge classification system will be presented to assist surgeons in diagnosing appendiceal duplications.
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    ABSTRACT: Duplication of appendix with other congenital anomalies is rare.•They have clinical and medicolegal significance.•Surgeons should be aware of these conditions because of the possible clinical implications.
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    ABSTRACT: BackgroundDuplication of the appendix is a rare anomaly. To date, about 100 such cases have been recorded in the English literature, and although two cases are described as horseshoe appendices, none referred the unique configuration with a single tip presented in this case report. Case reportA 20-year-old woman presented with a two-day history of right iliac fossa pain. An appendicectomy was performed along with a lymph node excisional biopsy. Histological examination revealed a horseshoe double appendix and an incidental high grade B-cell non-Hodgkin lymphoma. ConclusionsDespite its rarity, failure to recognize appendiceal duplication may have serious clinical and medico-legal consequences. As in our case, this anomaly may be an incidental finding, highlighting the need for increased awareness of the condition, especially amongst junior doctors. A lymphoma may present with a non-specific abdominal pain. Our case presented as an acute appendicitis which prompted us to proceed with surgical exploration. Based on our findings and the review of the relative literature, we propose a modification of the existing classification of appendicial duplication. KeywordsDouble appendix-Duplication-Horseshoe appendix
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