Zvizdic Zlatan, Bukvic Melika, Ibisevic Nermina, Firdus Alena, Jonuzi Asmir, Vranic Semir
Department of Pediatric Surgery, Clinical Center University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina.
Department of Radiology, Clinical Center University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina.
J Surg Case Rep. 2024 Dec 19;2024(12):rjae784. doi: 10.1093/jscr/rjae784. eCollection 2024 Dec.
Duplication of the vermiform appendix is a rare anomaly observed in patients undergoing appendectomy. A 27-month-old male toddler presented with a 9-day history of abdominal pain, vomiting, and diarrhea, progressing to an acute abdomen with signs of severe peritonitis. Intraoperative findings revealed a periappendicular infiltrate from a perforated vermiform appendix of the tenia coli type. A second, inflamed appendix was incidentally discovered in its typical location during the procedure. Vermiform appendix duplication presents a clinical challenge due to its rarity and potential for complications. According to the Cave-Wallbridge classification, this case represents Type B2, or the tenia coli variant, characterized by a perforated appendix originating at the tenia coli convergence and a smaller, secondary appendix in a retrocecal position. This case emphasizes the importance of thorough distal and proximal exploration during initial appendectomy when this anomaly is suspected, particularly in cases of Type B2.
阑尾重复是在接受阑尾切除术的患者中观察到的一种罕见异常。一名27个月大的男童出现腹痛、呕吐和腹泻9天病史，病情进展为伴有严重腹膜炎体征的急腹症。术中发现结肠带型穿孔阑尾周围有浸润。手术过程中偶然在其典型位置发现了第二个发炎的阑尾。阑尾重复因其罕见性和潜在并发症而带来临床挑战。根据凯夫-沃尔布里奇分类法，该病例属于B2型，即结肠带变异型，其特征是起源于结肠带汇合处的穿孔阑尾以及位于盲肠后位的较小的副阑尾。该病例强调了在怀疑存在这种异常时，初次阑尾切除术中进行彻底的远近端探查的重要性，尤其是在B2型病例中。
