Duplex vermiform appendix: case report of a ruptured second appendix

Travis, John; Weppner, Justin; Paugh, James C.

doi:10.1016/j.jpedsurg.2008.04.023

Cited by 37 publications

(33 citation statements)

References 6 publications

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“…[1,2] Cave and Wallbridge classified appendical duplication by their anatomical localization into three groups. Type A refers to incomplete duplication, where both appendixes arise from a common base from the cecum.…”

Section: Discussionmentioning

confidence: 99%

“…Apendiks duplikasyonunda çift akut apandisit Semra TUTCU ŞAHİN, 1 Yamaç ERHAN, 2 Hasan AYDEDE 2 Appendiks vemiformis duplikasyonu nadir bir doğumsal anomalidir ve genellikle laparotomi esnasında tesadüfen saptanır. Apendikslerin birinin diğerine ve çekuma göre lokalizasyonunu tanımlamada ve aynı zamanda duplikasyonun boyutunu göstermede modifiye Cave ve Wallbridge sınıflaması kullanılır.…”

Section: Double Acute Appendicitis In Appendical Duplicationunclassified

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Double acute appendicitis in appendical duplication

Şahin¹,

Erhan²,

Aydede³

2013

Ulus Travma Acil Cerrahi Derg

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Appendiks vemiformis duplikasyonu nadir bir doğumsal anomalidir ve genellikle laparotomi esnasında tesadüfen saptanır. Apendikslerin birinin diğerine ve çekuma göre lokalizasyonunu tanımlamada ve aynı zamanda duplikasyonun boyutunu göstermede modifiye Cave ve Wallbridge sınıflaması kullanılır. Bu yazıda akut karın ağrısı nedeniyle laparotomi uygulanan 45 yaşında bir hasta sunuldu. Operasyon bulguları, apendiks duplikasyonu ile birlikte çift akut apandisit şeklinde idi. Tip B duplikasyon olması nedeniyle apendiksler ayrı ayrı alındı. Apendektomi en sık uygulanan abdominal cerrahi olması nedeniyle tüm cerrahlar bu nadir klinik antiteyi akılda tutmalıdırlar.Anahtar Sözcükler: Apandisit; duplikasyon; appendiks vemiformis.Duplication of the vermiform appendix is a rare congenital abnormality and usually found incidentally during laparotomy. The Modified Cave-Wallbridge classification is used to describe the location of the appendixes in relation to each other and to the cecum as well as the extent of the duplication. We report a 45-year-old patient who underwent laparotomy for acute abdominal pain. The operative finding was double acute appendicitis in appendical duplication. The appendixes were removed separately, as it was type B duplication. Since appendectomy is the most common abdominal operation, all surgeons should keep this rare clinical entity in mind.Key Words: Appendicitis; duplication; vermiform appendix.Appendical duplication is a rare abnormality, with an estimated incidence of 0.004% among patients undergoing appendectomy. [1,2] We report a case of appendical duplication presented with double acute appendicitis. CASE REPORTA 45-year-old male presented with right lower quadrant pain, anorexia, nausea, and vomiting. The pain started in the epigastric region three days ago, and then intensified in severity with migration to the right lower quadrant. On physical examination, rigidity and rebound tenderness were noted in the right lower quadrant. The patient was febrile and tachycardic. White blood cell count was 21900/mm 3 . Other laboratory values were normal. Plain abdomen and chest X-rays appeared normal. Pelvic ultrasound in the emergency suite showed minimal periappendicular fluid and a non-peristaltic, non-compressible tubular structure with a diameter of 10 mm.McBurney incision was extended with the help of several retractors for optimal display of the surgical region, as shown in Figure 1. During exploration through the McBurney incision, a small amount of inflammatory fluid was noted. After cecal mobilization, two appendixes were seen: one on the corner where the taenia coli converge, and the other just next to it, with two separate bases. They shared the same mesoappendix, and both were erectile, hyperemic and inflamed; however, one was gangrenous and showed serosal necrosis (Figs. 1, 2). Routine appendectomy was performed for each. The postoperative period was uneventful, and the patient was discharged on the 3rd postoperative day.On pathological examination, the appendixes measured 5x0.7 cm and...

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Section: Discussionmentioning

confidence: 99%

Section: Double Acute Appendicitis In Appendical Duplicationunclassified

Double acute appendicitis in appendical duplication

Şahin¹,

Erhan²,

Aydede³

2013

Ulus Travma Acil Cerrahi Derg

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“…In type C, there are two caecums [12], each with its own appendix. A type D has been schematically proposed that includes a horseshoe appendiceal duplication [13]. This is the third case to be reported in the literature with a similar horseshoe shape and can be regarded as a subtype of D: an appendix with double appendiceal bases of a horseshoe configuration and a single tip.…”

Section: Introductionmentioning

confidence: 91%

A horseshoe double appendix positioned on a non-Hodgkin lymphoma

et al. 2010

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“…The reported incidence is 0.004-0.009% (approximately 80 reported cases). 1,2 Preoperative diagnosis of appendiceal duplication is often difficult and it is usually made at surgery. Almost all cases are detected in childhood and they are almost always associated with major malformation of the intestinal tract, genitourinary system or vertebrae.…”

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confidence: 99%

Duplication of the vermiform appendix in an adult patient

Lim

2014

annals

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Duplication of the appendix is extremely rare. A 69-year-old woman was admitted with a 2-day history of right lower quadrant abdominal pain. Physical examination was consistent with acute appendicitis. Ultrasonography and colonoscopy gave a clinical impression of an inflammatory appendiceal mucocoele. Operative findings were an enlarged and inflamed appendix with distal cystic changes. Laparoscopic wedge resection of the caecum was performed. A tubular structure with a true lumen was found in the appendix. Haematoxylin and eosin staining and trichrome staining showed both structures had a true mucosa and a muscular layer. The duplication in this case does not belong to any of the previously described types of duplication.

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Duplex vermiform appendix: case report of a ruptured second appendix

Cited by 37 publications

References 6 publications

Double acute appendicitis in appendical duplication

Double acute appendicitis in appendical duplication

A horseshoe double appendix positioned on a non-Hodgkin lymphoma

Duplication of the vermiform appendix in an adult patient

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