[Acute appendicitis in a boy with an earlier appendectomy and a second appendix]

A 17-year-old boy who had already undergone appendectomy, presented with a one-day history of severe pain in his right lower abdomen. Physical examination and other investigations indicated acute appendicitis. On exploratory laparotomy, a second, inflamed appendix was found. Appendectomy was carried out, and the patient made a good recovery. Pathological examination of the organs removed at each operation confirmed that during both procedures an intact and clearly inflamed appendix had been removed. A double appendix is a rare clinical entity and may be associated with other congenital abnormalities. Doctors should be aware of the possibility of appendiceal duplication to avoid delay in diagnosis and treatment.