Abstract
Background
Duplication of the appendix is a rare anomaly. To date, about 100 such cases have been recorded in the English literature, and although two cases are described as horseshoe appendices, none referred the unique configuration with a single tip presented in this case report.
Case report
A 20-year-old woman presented with a two-day history of right iliac fossa pain. An appendicectomy was performed along with a lymph node excisional biopsy. Histological examination revealed a horseshoe double appendix and an incidental high grade B-cell non-Hodgkin lymphoma.
Conclusions
Despite its rarity, failure to recognize appendiceal duplication may have serious clinical and medico-legal consequences. As in our case, this anomaly may be an incidental finding, highlighting the need for increased awareness of the condition, especially amongst junior doctors. A lymphoma may present with a non-specific abdominal pain. Our case presented as an acute appendicitis which prompted us to proceed with surgical exploration. Based on our findings and the review of the relative literature, we propose a modification of the existing classification of appendicial duplication.
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References
Bluett MK, Halster SA, Salhany KE, O’Leary JP. Duplication of the appendix mimicking adenocarcinoma of the colon. Arch Surg 1987;122(7):817–820 [PMID:3297001]
J Martin Johnston. Non-Hodgin Lymphoma. http://emedicine.medscape.com/article/987540-overview
Macpherson RI. Gastrointestinal tract duplications: clinical, pathologic, etiologic and radiologic considerations. Radiographics 1993;13:1063–1080 [PMID:8210590]
Puligandla PS, Nguyen LT, St-Vil D, Flageole H, Bensoussan AL, Nguyen VH, Laberge JM. Gastrointestinal duplications. J Pediatr Surg 2003;38:740–744 [PMID:12720184]
Kabay S, Yucel M, Yaylak F, Hacioglu A, Algin MC, Olgun EG, Sabin L, Aydin T. Combined duplication of the colon and vermiform appendix in an adult patient. World J Gastroenterol 2008;14(4):641–643 [PMID:18203303]
Collins DC. A study of 50,000 specimens of the human vermiform appendix. Surg Gynecol Obstet 1955;101:437–446 [PMID:13256319]
Mesko TW, Lugo R, Breicholz T. Horseshoe anomaly of the appendix: a previously undescribed entity. Surgery 1989;106:563–566 [PMID:2772830]
DasGupta R, Reber UP, Patel GA. Horseshoe appendicitis. Eur J Surg 1999;165:1095–1096 [PMID:10595618]
Wallbridge PH. Double appendix. Br J Surg 1962;50:346–347 [PMID:13998581]
Biermann R, Borsky D, Gogora M,. Die Appendicitis duplexeine pathologische Raritat. Chirurg 1993;64:1059–1061
Kjosscv KT, Lossanoff JE. Duplicated vermiform appendix. Br J Surg 1996;83:1259
Kim EP, McClenathan JH. Unusual duplication of the appendix and cecum: extension of the Cave-Wallbridge classification. J Pediatr Surg 2001;36(9):E18 [PMID:11528635]
Travis J, Weppner J, Caugh J. Duplex vermiform appendix: case report of a ruptured second appendix. J Pediatr Surg 2008 Sep;43(9):1726–1728
Kothari AA, Yagnik KR, Hathila VP. Duplication of the vermiform appendix. J. Postgrad Med 2004;50:285–286[PMID:15623973]
Yanar H, Ertekin C, Unal ES, Taviloglu K, Guloglu R, Mete O. The case of acute appendicitis and appendiceal duplication. Acta Chir Belg 2004;104(6):736–738 [PMID:15663287
Chew DK, Borromeo JR, Gabriel YA, Holgersen LO (2000)Duplication of the vermiform appendix. J Pediatr Surg 2002;35(4):617–618 [PMID:10770397]
Mitchell IC, Nicholls JC Duplication of the appendix. Report of a case: review of the classification and medicolegal aspects. Med Sci Law 1990;30(2):124–126 [PMID:2348765]
Bethel CA, Bhattacharyya N, Hutchinson C, et al. Alimentary tract malignancies in children. J Pediatr Surg. Jul 1997;32(7):1004–1008;discussion 1008–9.
Arensman R, Abramson L, Madonna MB, Stephens DJ. Gastrointestinal Neoplasms.
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Ninos, A., Douridas, G., Papakonstantinou, E. et al. A horseshoe double appendix positioned on a non-Hodgkin lymphoma. Hellenic J Surg 82, 73–76 (2010). https://doi.org/10.1007/s13126-010-0003-0
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DOI: https://doi.org/10.1007/s13126-010-0003-0