Shibata Jumpei, Tomida Akihiro, Hattori Masaoki, Hirata Akihiro, Imataki Hiromitsu, Orihara Yukiya, Shintomi Hideharu, Aono Keiya, Yoshihara Motoi
Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan.
Surg Case Rep. 2023 Oct 30;9(1):190. doi: 10.1186/s40792-023-01769-7.
This case report highlights the exceptional rarity of appendix duplication in adults, a condition that closely mimics appendiceal tumors, posing diagnostic challenges. The novelty of this case lies in its presentation of a Type A duplication, emphasizing the diagnostic intricacies involved in distinguishing it from other pathologies.
We present the case of a 69-year-old male with a history of hypertension, hyperuricemia, and duodenal gastric ulcer, who presented with a positive occult blood test. Lower gastrointestinal endoscopy revealed an appendiceal orifice with atypical hyperemia and edema. Subsequent imaging and biopsy results suggested an appendiceal tumor, prompting laparoscopic ileocecal resection. Intraoperative findings revealed an unremarkable appendix, but histopathological analysis unveiled appendiceal duplication, characterized by bifurcation into two lumens within a thick serosal wall. The patient was discharged without complications.
This case underscores the importance of recognizing appendix duplication as a rare differential diagnosis for appendiceal tumors. Surgeons should remain vigilant, especially in cases of Type A duplication, where preoperative diagnosis remains challenging. Early identification can avert potential complications and missed congenital anomalies.
本病例报告凸显了成人阑尾重复畸形极为罕见，这种情况与阑尾肿瘤极为相似，给诊断带来了挑战。该病例的新颖之处在于呈现了A型重复畸形，强调了将其与其他病理情况区分开来所涉及的诊断复杂性。
我们报告一例69岁男性病例，有高血压、高尿酸血症和十二指肠胃溃疡病史，隐血试验呈阳性。下消化道内镜检查发现阑尾开口处有非典型充血和水肿。随后的影像学和活检结果提示为阑尾肿瘤，遂行腹腔镜回盲部切除术。术中发现阑尾外观无异常，但组织病理学分析显示为阑尾重复畸形，其特征是在厚厚的浆膜壁内分为两个管腔。患者出院，无并发症。
本病例强调了认识阑尾重复畸形作为阑尾肿瘤罕见鉴别诊断的重要性。外科医生应保持警惕，尤其是在A型重复畸形的病例中，术前诊断仍然具有挑战性。早期识别可避免潜在并发症和漏诊先天性异常。
