"Double Appendix" Associated With Other Congenital Anomalies

Abstract

The following case is presented because it is believed to be the first reported instance of "double appendix" arising as a congenital malformation and unassociated with inflammation. This and other anomalies of the intestinal tract in the patient bear a striking resemblance to the avian alimentary tract. "Double appendix" appears in quotation marks, for the "appendixes" are believed to be the homologs of avian ceca rather than true appendixes. The possibility of two appendixes in one person may have important medicolegal significance.A summary of the clinical data and a condensation of the pathologic report follow : REPORT OF CASEHistory.\p=m-\L.A., a white male infant, entered the hospital on July 29, 1931, at the age of 11 hours, because of an imperforate anus. He was born at full term; the delivery was normal. X-ray plates taken with the patient in an inverted position showed no air-filled intestine in the pelvis or near the anus. On this evidence a sigmoidostomy was performed, with immediate evacuation of a considerable amount of meconium.Course.-After operation, the patient ran a septic type of temperature. Irriga¬ tions were continued through the Mixter tube, and bowel movements were normal in number by this route. The patient went gradually downhill and died on August 13, fifteen days after entry.The urine contained from 2 to 3 white cells per high power field. The clinical diagnosis was imperforate anus. Autopsy.-This was performed at the Children's Hospital on August 13, four hours post mortem. There were no restrictions.Body : The body was that of a well developed and moderately well nourished, white, male infant measuring 52.5 cm. in length. Rigor mortis was moderate in the hands and jaw and was otherwise absent. Postmortem lividity was slight in the dependent portions. There were no skeletal deformities. The lips were cyanotic. The abdomen was flat, and no organs could be palpated. There was a right rectus operative incision measuring 4 cm. in length. There were no sutures or drainage tubes. The wound was wide open, and loops of intestine could be seen beneath it. The edges were indurated and reddened. The anus was imperforate, being represented by a dimple in the skin not more than 0.5 cm. deep. The body was otherwise normal.

Apendicitis crónica en un apéndice atrófico: reporte de un caso

“…La duplicación apendicular suele ser un hallazgo incidental en el curso de una laparotomía o en estudios de imágenes. Se reportan de 60 a 80 casos desde que fue descrito inicialmente (16)(17)(18)(19)(20) en 1903…”

Appendix Vermiformis Duplex

“…Emrys-Roberts and Paterson (1906) casually reported such a condition in their detailed description of a stillborn full term fetus which exhibited ectopia of the viscera, spina bifida and many other abnor¬ malities. The second case of this type was described by Pratt (1933), and Del Plaine (1936) has added a third. In this last case there were a defect in the anterior abdominal wall, agenesis of the bladder, a double uterus and a double vagina.…”