Appendiceal duplication with simultaneous acute appendicitis and appendicular perforation causing small bowel obstruction

Abstract

Acute appendicitis, as well as intestinal obstruction, is a common surgical emergencies. Both the conditions can present as an acute abdomen, however the diagnosis of acute appendicitis can be overlooked when it presents as a small bowel obstruction. Difficulties in correctly identifying the cause of pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. Appendiceal duplication although rare and difficult to diagnose preoperatively, should be checked while operating for appendicular pathology in order to avoid serious clinical and medicolegal implications.We hereby report a case of appendiceal duplication presenting as small bowel obstruction with one appendix having acute appendicitis and the other one perforated in the middle third.

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

“…Peritoneal adhesions, which were found in up to 95% of patients after intra‐abdominal surgery, are the leading cause of SBOs 10,19–21 . When it comes to appendicitis, previous studies reported the rate of adhesive SBO after LA to be 1.4% 22–24 . In our study, 16 cases were included in the SBO group.…”

“…10,[19][20][21] When it comes to appendicitis, previous studies reported the rate of adhesive SBO after LA to be 1.4%. [22][23][24] In our study, 16 cases were included in the SBO group. Standard conservative management was successful in 14 patients, and operative therapy was recommended for those who failed conservative therapy in our study.…”

Case report of the duplex vermiform appendix: A rare presentation in an elderly patient

“…Several classifications have been described to classify a double appendix. The most commonly used is the Cave–Wallbridge classification [4] . These classification are A, B1, B2 and C. However this has been updated to include other subtypes like the horseshoe appendix and triplet appendix [4] , [5] (see Table 1 ).…”

“…The most commonly used is the Cave–Wallbridge classification [4] . These classification are A, B1, B2 and C. However this has been updated to include other subtypes like the horseshoe appendix and triplet appendix [4] , [5] (see Table 1 ). The diagnosis can either be an incidental finding on imaging or through complicated presentations.…”

“…The diagnosis can either be an incidental finding on imaging or through complicated presentations. Among these complications are acute appendicitis, colonic perforation, obstruction, intussusception, bleeding, pain, failure to thrive and abdominal mass [4] , [5] , [6] , [7] .…”