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Deflaoui T, Derkaoui A, Mahmoudi M, Akil Y, Amara R, Miry N, Amal B, Jabi R, Bouziane M. Appendiceal duplication: a case report of horseshoe-shaped appendix and implications for patient safety. J Surg Case Rep 2024; 2024:rjae075. [PMID: 38389513 PMCID: PMC10881288 DOI: 10.1093/jscr/rjae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Appendiceal anomalies, particularly double appendices, are rare and mainly detected during non-appendiceal surgery in adults. Misrecognizing them can have serious consequences, both clinically and legally. It is critical that surgeons pay attention to the anatomical variations of the vermiform appendix, and always consider the possibility of duplicated appendix when diagnosing a right iliac fossa pain. Misdiagnosis can lead to life-threatening medical complications for the patient, with medico-legal implications.
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Affiliation(s)
- Tarik Deflaoui
- Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco
| | - Anas Derkaoui
- Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco
| | - Mohammed Mahmoudi
- Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco
| | - Yassir Akil
- Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco
| | - Rihab Amara
- Departement of Medicine, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Nadir Miry
- Department of Pathology, Mohammed VI University Hospital, Oujda, Morocco
| | - Benani Amal
- Department of Pathology, Mohammed VI University Hospital, Oujda, Morocco
| | - Rachid Jabi
- Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco
- Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Mohammed Bouziane
- Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco
- Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
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Rahul S, Keshri R, Prasad R, Chaubey D, Hasan Z, Kumar V, Thakur V, Yadav R, Kumar R, Bakhtiyar A. Duplications of the alimentary tract in infants and children. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_137_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Appendiceal Duplication: A Comprehensive Review of Published Cases and Clinical Recommendations. World J Surg 2018; 42:574-581. [PMID: 28799135 DOI: 10.1007/s00268-017-4178-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Duplex appendix is very rare (incidence 0.004%) but has clinical relevance given the frequency of appendicectomies performed. Failure to recognise duplication can result in failure of treatment and medico-legal consequences. A review of published cases was undertaken to identify factors that may help in managing this rare condition. METHODS All English and non-English publications were identified in PubMed, Embase and Cochrane databases. Patient demographics, intraoperative findings, anatomical details and histopathology were analysed. RESULTS A total of 141 cases were identified [male/female ratio 1.4:1, median age 20 years (range foetus to 69 years)]. Duplication of the appendix ranges from branching of the appendix trunk to a fully matured appendix located elsewhere along the colon. Most can be categorised by the Cave-Wallbridge classification. There were 22 Type A, 8 Type B1, 46 Type B2 and 10 Type C cases (Cave-Wallbridge). There were six cases of horseshoe and two cases of triple appendix. Six reports gave anatomical descriptions that could not be classified by Cave-Wallbridge categories and in 11 cases there were no anatomical descriptions. CONCLUSIONS An anteriorly placed appendix, away from the convergence of the taenia, or a normal appendix in the presence of convincing clinical or radiological signs of appendicitis should instigate a careful examination of the caecal pole and possible exploration of the retrocaecal space for appendiceal duplication. If the patient had previous surgery for congenital abnormalities, Type B1 or Type C duplication should be considered.
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Azahouani A, Hida M, Benhaddou H. [Colonic duplication revealed by intestinal obstruction due to fecal impaction]. Arch Pediatr 2015; 22:1284-7. [PMID: 26552633 DOI: 10.1016/j.arcped.2015.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 06/15/2015] [Accepted: 09/23/2015] [Indexed: 11/17/2022]
Abstract
Colonic duplications are very rare in children. With rectal duplications, they are the rarest locations of alimentary tract duplications, most often diagnosed in the first years of life. We report an unusual case of colic duplication with fecal impaction in a 9-month-old boy revealed by intestinal obstruction. We discuss the main diagnostic and therapeutic aspects of this malformation.
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Affiliation(s)
- A Azahouani
- Service de chirurgie pédiatrique, hôpital Alfarabi, Oujda, faculté de médecine et de pharmacie d'Oujda, université Mohamed premier, Oujda, Maroc.
| | - M Hida
- Service de chirurgie pédiatrique, hôpital Alfarabi, Oujda, faculté de médecine et de pharmacie d'Oujda, université Mohamed premier, Oujda, Maroc
| | - H Benhaddou
- Service de chirurgie pédiatrique, hôpital Alfarabi, Oujda, faculté de médecine et de pharmacie d'Oujda, université Mohamed premier, Oujda, Maroc
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Aggouri Y, Ossibi PE, Oussaid M, Tourghai I, Hassani KIM, laalim SA, Mazaz K. [Duplication of the appendix revealed during a recurrent appendicitis syndrome]. Pan Afr Med J 2015; 20:335. [PMID: 26175825 PMCID: PMC4491471 DOI: 10.11604/pamj.2015.20.335.6658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 04/04/2015] [Indexed: 01/07/2023] Open
Abstract
La duplication appendiculaire est une malformation très rare. Elle se rencontre chez les enfants exceptionnellement chez les adultes. Sa découverte est souvent fortuite à l'occasion d'une laparotomie ou laparoscopie pour une autre pathologie. Nous rapportons un cas particulier d'un patient qui a bénéficié d'une appendicectomie il y'a 3 mois qui est admis aux urgences pour un syndrome appendiculaire récidivant avec aux explorations radiologique et chirurgicale la présence d'une appendicite rétrocoecale.
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Affiliation(s)
- Younes Aggouri
- Département de Chirurgie Générale (B), CHU Hassan II, Fès, Maroc
| | | | - Mourad Oussaid
- Département de Chirurgie Générale (B), CHU Hassan II, Fès, Maroc
| | - Imane Tourghai
- Département de Chirurgie Générale (B), CHU Hassan II, Fès, Maroc
| | | | - Said Ait laalim
- Département de Chirurgie Générale (B), CHU Hassan II, Fès, Maroc
| | - Khalid Mazaz
- Département de Chirurgie Générale (B), CHU Hassan II, Fès, Maroc
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Jellali MA, Mekki M, Saad J, Zrig A, Elanes I, Mnari W, Maatouk M, Harzallah W, Toumi S, Krichène I, Salem R, Nouri A, Golli M. Perinatally discovered complete tubular colonic duplication associated with anal atresia. J Pediatr Surg 2012; 47:e19-23. [PMID: 22703820 DOI: 10.1016/j.jpedsurg.2012.01.082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 01/17/2012] [Accepted: 01/24/2012] [Indexed: 12/18/2022]
Abstract
Complete tubular colonic duplication (CTCD) is exceedingly rare. The association of CTCD with an anorectal malformation is unusual. This malformation may be found unexpectedly at laparotomy. We present 3 cases of surgically proven neonate CTCD discovered at laparotomy for anal atresia. We reviewed the mode of clinical presentation, the imaging, and laparotomy findings. Our series illustrates that this rare disease presents perinatally in association with anal atresia, with or without other associated anomalies.
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Affiliation(s)
- Mohamed A Jellali
- Department of Radiology, CHU Fattouma-Bourguiba, 1st JUNE Street, Monastir 5000, Tunisia.
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Mahmood A, Mahmood NF, Williams JL. Acute abdominal pain presenting as a rare appendiceal duplication: a case report. J Med Case Rep 2012; 6:79. [PMID: 22397591 PMCID: PMC3310715 DOI: 10.1186/1752-1947-6-79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 03/08/2012] [Indexed: 02/08/2023] Open
Abstract
Introduction Appendiceal duplication is a rare anomaly that can manifest as right lower quadrant pain. There are several variations described for this condition. We recommend aggressive operative management should this anatomical variation present in the presence of acute appendicitis. Case presentation We report the case of a 15-year-old African American girl who presented to our hospital with right lower quadrant pain and was subsequently found to have appendiceal duplication. Conclusion There are two categorical systems that have described and stratified appendiceal duplication. Both classification systems have been outlined and referenced in this case report. A computed tomography scan has been included to provide a visual aid to help identify true vermiform appendiceal duplication. The presence of this anatomical abnormality is not a reason for surgical intervention; however, should this be found in the setting of acute appendicitis, aggressive resection of both appendices is mandatory.
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Affiliation(s)
- Ali Mahmood
- Clinical Faculty, Department of Surgery, Minimally Invasive Surgery Consortium, University of Texas Medical School at Houston, 16605 SW Freeway, Suite 430, Sugar Land, TX 77479, USA.
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Oğuzkurt P, Oğuzkurt L, Kayaselcuk F, Oz S. An unusual cause of acute abdomen: torsion of colonic duplication over a duplicated appendix. Pediatr Surg Int 2004; 20:722-3. [PMID: 15449085 DOI: 10.1007/s00383-004-1283-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2003] [Indexed: 12/29/2022]
Abstract
A 2-year old boy with torsion of colonic duplication, which had a proximal communication with the cecum via an incomplete duplicated appendix, is presented. The clinical picture and complications of this rare association are discussed.
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Affiliation(s)
- Pelin Oğuzkurt
- Department of Pediatric Surgery, Başkent University, Adana Medical Center, Dadaloğlu Mah. 39 Sokak, No 6, 01220, Adana, Turkey.
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Dogra PN, Ansari MS, Goel A, Prashad R, Sharma S. Radiopaque shadow in the lumbar region on plain X-ray abdomen: diagnostic dilemma. Int Urol Nephrol 2003; 34:485-7. [PMID: 14577489 DOI: 10.1023/a:1025619002815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A 28-year-old man presented with right flank pain. Radiological investigations suggested the diagnosis of a calcified mass in the retroperitoneum below the right kidney. Laparoscopic exploration using the retroperitoneoscopic approach was performed. However, it was not possible to locate the lesion and an open exploration was done. During exploration a large fecolith was found trapped in a diverticulum of the cecum.
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Affiliation(s)
- P N Dogra
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
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Kim EP, McClenathan JH. Unusual duplication of appendix and cecum: extension of the Cave-Wallbridge classification. J Pediatr Surg 2001; 36:E18. [PMID: 11528635 DOI: 10.1053/jpsu.2001.26400] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Duplicated appendix has, to date, been classified into 3 types. The authors present a type of duplicated appendix not previously described. Surgical exploration was done in a 14-year-old girl who had an acute abdomen. Surgical exploration showed a duplicated appendix that arose from the normal appendix and ended in a thick-walled, inflamed, perforated muscular pouch. Duplicated appendix is a treatable condition that rarely occurs with colonic duplication and which should be considered in the differential diagnosis of lower abdominal pain.
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Affiliation(s)
- E P Kim
- Department of Surgery, Stanford University Medical Center, Stanford, CA, USA
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Abstract
In this brief report, the authors present a case of duplication of the vermiform appendix with appendicitis occurring in both appendices and causing small bowel obstruction.
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Affiliation(s)
- D K Chew
- Division of Pediatric Surgery, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA
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