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[Appendix vermiformis duplex--a rare surprise].

Babak Sobhian1, Margit Mostegel, Claudia Kunc

  • 1Chirurgische Abteilung, Kaiser-Franz-Josef-Spital, Sozialmedizinisches Zentrum Süd, Wien, Osterreich. sobhian19@yahoo.com

Wiener Klinische Wochenschrift
|August 11, 2005
PubMed
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Duplication of the vermiform appendix (appendix duplex) is a rare condition. Surgeons should consider this possibility in complex appendicitis cases, even if the appendix appears normal during surgery.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Anatomy

Background:

  • Vermiform appendix duplication is an exceptionally rare congenital anomaly, affecting approximately 0.004% of patients undergoing appendectomy for acute appendicitis.
  • This case report details a 60-year-old male presenting with a peridiverticular sigmoid abscess, necessitating a Hartmann's resection and initial appendectomy.

Observation:

  • The initial appendectomy revealed the vermiform appendix as part of the abscess wall, with pathology noting external appendicitis.
  • Following successful intestinal anastomosis three months later, a second, retrocecal vermiform appendix was unexpectedly discovered during cecal mobilization.
  • The second appendix exhibited signs consistent with chronic appendicitis, leading to a secondary resection.

Findings:

  • The patient was diagnosed with appendix duplex, a condition characterized by the presence of two vermiform appendices.

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  • Pathological examination confirmed the presence of two distinct vermiform appendices in the same patient.

    • Implications:

    • While rare, appendix duplex should be considered in surgical practice, particularly when clinical presentations of appendicitis are atypical or intraoperative findings are unusual.
    • Routine exploration for a second appendix is not recommended due to its rarity and the potential for increased surgical complications.