Bifid Vermiform Appendix: A Case Report

Griffiths, Ewen A.; Jagadeesan, Jayaraman; Fasih, Tarannum; Mercer-Jones, Mark

doi:10.1016/j.cursur.2006.02.001

Cited by 17 publications

(15 citation statements)

References 11 publications

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“…More recently, cases that do not fit into this classification system have been described as the "horseshoe appendix" or "triple appendix". [5] We thus believe either a new classification system is needed to design appendiceal anomalies, or the present system should be modified. Previously reported horseshoe appendix cases have either been diagnosed during interval appendectomy or found incidentally during abdominal surgery for other reasons.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An extremely rare appendiceal anomaly: horseshoe appendicitis

Oruç¹,

Işık²,

Üreyen³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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Appendiceal anomalies are extremely rare malformations that are usually found in adult populations as an incidental finding. Agenesis and duplication of the appendix have been well documented, but we know of only three reported cases of a horseshoe appendix. A 64-year-old woman admitted to the emergency department. A provisional diagnosis of acute appendicitis was made, and the patient was taken to the operating room. While appendectomy was being performed with a standard approach, the distal tip was seen to communicate with the cecum by another stump, or "horseshoe appendix". The aim of this report is to share our experience with this extraordinary finding.Key Words: Appendix vermiformis; horseshoe; malformation.Apendiks anomalileri çoğunlukla erişkin popülasyonda rastlantı sonucu bulunan çok nadir malformasyonlardır. Apendiks agenezis ve duplikasyonu iyi bilinmesine rağ-men, bildirilmiş sadece üç adet atnalı apendiks olgusu bulunduğunu biliyoruz. Acil servise başvuran 64 yaşında kadın hasta akut apandisit ön tanısı ile ameliyathaneye alındı. Standart yaklaşımla apendektomi uygulanırken, "at nalı apendiks" şeklinde distal ucun ikinci bir güdük ile çekumla bağlantılı olduğu görüldü. Buradaki amacı-mız bu sıra dışı bulguyla ilgili deneyimimizi paylaşmak-tır.Anahtar Sözcükler: Appendiks vermiformis; at nalı; malformasyon.doi: 10.5505/tjtes.2013.67424 Appendiceal anomalies are extremely rare malformations that are usually found in adult populations as an incidental finding. Agenesis and duplication of the appendix have been well documented, and the incidences for these anomalies are 0.008% and 0.004%, respectively.[1] However, we know of only three reported cases of a horseshoe appendix. [2][3][4] In this report, we present the fourth case of a horseshoe appendix. CASE REPORTA 64-year-old woman admitted to the emergency department with a two-day history of right lower abdominal pain, nausea, and loss of appetite. The abdominal examination revealed right lower quadrant tenderness, guarding and rebound tenderness at McBurney's point. All laboratory study results were in normal ranges, and plain chest and abdominal radiographs showed no abnormality. Ultrasonographic examination determined pericecal minimal fluid collection. A provisional diagnosis of acute appendicitis was made, and the patient was taken to the operating room. A standard approach was taken with incision over McBurney's point. The cecum was identified, the taenia coli were followed to their confluence, and an appendiceal stump was found. The distal appendiceal tip was seen to extend to the posteromedial cecum, and there were adhesions that complicated mobilization of the appendix. A decision was made to perform retrograde appendectomy. After appendiceal stump and mesoappendix were ligated and divided, the distal tip was seen to communicate with the cecum by another stump, or "horseshoe appendix" (Figs. 1a, b). Appendectomy was completed. The patient made an uneventful recovery and was discharged two days later.

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Section: Discussionmentioning

confidence: 99%

“…[2] An appendiceal anomaly can be associated with other congenital abnormalities. [3][4][5] Preoperative radiological diagnosis of appendiceal anomalies is uncommon. Because of its particular rarity, most surgeons will never encounter a case of horseshoe appendix.…”

Section: Discussionmentioning

confidence: 99%

An extremely rare appendiceal anomaly: horseshoe appendicitis

Oruç¹,

Işık²,

Üreyen³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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“…En la parte más externa de la serosa y no visible copn este aumento, se puede apreciar una delgada capa superfi cial correspondiente a una periapendicitis, dada por un infi ltrado infl amatorio focal de polimorfonucleares, debido a la infl amación, gangrena y perforación del apéndice vecino. tipo bífi da en la cual una de ellas estaba gangrenada, insistiendo en las graves consecuencias que podría traer a futuro un segundo apéndice olvidado y no resecado 4 . Las variantes anatómicas incluyen: A) La ausencia congénita primaria, en la cual no existe ningún tipo de desarrollo apendicular; B) La atrofi a congénita o ausencia secundaria, en la cual existe un pequeño y delgado desarrollo apendicular de tan sólo algunos milímetros; C) La duplicación apendicular, que es la más frecuente de todas las variantes y que se analizará con más detalles en este reporte y D) La triple presentación apendicular, la que es extremadamente rara y que Trinckler reporta en un caso, asociado a otras anomalías como doble pene y ectopia vesical, como un hallazgo incidental en una laparotomía para la corrección de un conducto uretero-ileal anómalo 5 .…”

Section: Figura 2 Apendicitis Sano (Tinción H-e 40 Aumentos)unclassified

Duplicación del apéndice vermiforme

Grez

2011

Rev Chil Cir

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Double appendix. Case reportWe report a 37 years old male presenting with an acute appendicitis. The patient was operated, excising a gangrenous and perforated appendix. During closure a second appendix that was not infl amed, located three cm apart from the fi rst one, was observed. It was also excised and the pathologic report confi rmed that both surgical pieces corresponded to appendices, one infl amed and the other normal.Key words: Appendicitis, appendix, duplication. ResumenPresentamos el caso de un paciente de 37 años de edad, con clínica de apendicitis aguda que tras apendicetomía se pesquisó duplicación del apéndice vermiforme. La histología reveló infl amación aguda de uno de ellos. Esta rara anomalía ha sido descrita en menos de 100 casos. Se requiere un conocimiento de este infrecuente cuadro quirúrgico para un reconocimiento oportuno, ya que un error puede signifi car graves consecuencias clínicas para el paciente y médico legales para el cirujano.Palabras clave: Duplicación apendicular, apéndice supernumeraria, apendicitis aguda. CASOS CLÍNICOS IntroducciónLa duplicación del tracto digestivo es poco común, pero la del apéndice vermiforme es aún más rara. Basu et al, reportó 28 casos de duplicación del tracto digestivo sin encontrar un caso de duplicación del apéndice vermiforme 1 . Picoli, fue el primero en reportar una duplicación apendicular en una mujer que tenía además otro tipo de duplicaciones en el colon, órganos genitales internos, externos y vesicales.Gupta y Kak, en un estudio sobre el tema y recuento de casos de duplicación apendicular reportados, recolectaron menos de 50 casos 2 . Rivera, fue uno de los primeros en reportar en nuestro país el caso clínico de un joven de 22 años con duplicación apendicular con infl amación de sólo una de los apéndices resecados, informando en ese momento que no serían más de 60 a 80 los casos reportados con esta variación anatómica 3 . El objetivo de este trabajo es reportar el caso clínico de un paciente en que se pesquisó, en una apendicetomía de urgencia, esta rara patología.

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“…Approximately 100 cases of double Cecal appendix have been described so far worldwide with no case reported in Africa in general and Ethiopia in particular [2]. Intussusceptions, which are defined by Treves in 1899, as the prolapse of one part of the bowel into the lumen of the immediately adjoining part, may have a lead point, drawing the proximal bowel into the distal bowel by peristaltic activity.…”

Section: Introductionmentioning

confidence: 99%

A Case Report on Duplex Appendix in a Patient with Ileocolocolic Intussusceptions

Aberra¹

2017

J Gastrointest Dig Syst

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Duplex cecal appendix is a rare anatomical variation. Approximately 100 cases of double cecal appendix have been described so far. Till now there is no report of duplex appendix serving as a lead point in a patient with intussusceptions. This case report presents the first case of such presentation for the first time. This 6 month old female child presented with vomiting and diarrhea of week duration. She was tachycaridic, tachypniec and febrile. On abdominal examination she had distended and tender abdomen with hyper tympanic sound on percussion. She was irritable and had a sunken eye ball. She had leaukocytosis (20.8 × 10 3 ), hypokalemia (3.3 mmol/l) and hyponatremia (125 mmol/l). Abdominal ultrasounds were suggestive of intussusception. After stabilizing the patient we operated her for possible pre-operative diagnosis of SBO secondary to Intussusception. Intra-operatively it was an Ileocolocolic intussusception with duplex appendix as a leading point. We did resection and anastomosis. Post operatively she was transfused with two units of blood (20 ml/kg), given IV antibiotics, analgesics and followed with vital sign sheet (Table 1). She started PO feeding after 36 hours post operation and discharged on the 7 th day improved. The case is extremely important for the study of this possible anatomical variation and its association with intussusceptions. It also serves as an input for future studies in the area. Moreover, its association with the presence of other anatomical variations such as intestinal, genitourinary and bone is important. And reporting such a rare case is very essential in the development of surgical practice.

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Bifid Vermiform Appendix: A Case Report

Cited by 17 publications

References 11 publications

An extremely rare appendiceal anomaly: horseshoe appendicitis

An extremely rare appendiceal anomaly: horseshoe appendicitis

Duplicación del apéndice vermiforme

A Case Report on Duplex Appendix in a Patient with Ileocolocolic Intussusceptions

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