Pflieger Hannah, Tchikladzé-Mérand Christine
Visceral and digestive surgeon, Hôpital Privé Guillaume de Varye, ELSAN, Saint-Doulchard, France.
Biostatistician, ELSAN, Paris, France.
Medicine (Baltimore). 2025 Feb 28;104(9):e41425. doi: 10.1097/MD.0000000000041425.
Horseshoe appendix is 1 of the rarest types of duplex appendix characterized by 1 appendix having 2 openings at the cecum. Clinically, it is extremely rare and is detected incidentally at surgery. Therefore, accurate and timely diagnosis is important for enhanced prognosis, treatment planning, and optimizing patient outcomes. This case report presents the first case of horseshoe appendix in France.
A French 15-year-old boy, presented to the emergency department with pain in the right iliac fossa that had been worsening for 4 days. Considering his symptoms, abdominal ultrasound, radiological examination, and computed tomography (CT) scan results, an acute appendix was suspected.
Acute appendicitis (AA) with "horseshoe" type appendix.
Surgical intervention with exploratory laparoscopy was performed immediately.
We found a heterogeneous image, partially fluid in the right iliac fossa, measuring approximately 16 × 9 mm, with inflammatory remodeling of the fat upon contact. The radiological examination concluded that complicated AA was suspected. Finally, the pathological report revealed acute suppurative appendicitis with peritoneal reaction.
Horseshoe appendix is rare. Considering his symptoms, radiological examination, ultrasound, and CT scan results, an acute appendix was suspected. The patient was successfully treated using emergency surgery and antibiotics treatment thanks to further diagnosis via exploratory laparoscopy and pus microbial analysis.
马蹄形阑尾是最罕见的双阑尾类型之一，其特征为阑尾在盲肠处有两个开口。临床上，这种情况极为罕见，多在手术中偶然发现。因此，准确及时的诊断对于改善预后、制定治疗方案及优化患者治疗效果至关重要。本病例报告介绍了法国首例马蹄形阑尾病例。
一名15岁法国男孩因右下腹疼痛4天加重前来急诊科就诊。综合其症状、腹部超声、放射学检查及计算机断层扫描（CT）结果，怀疑为急性阑尾炎。
急性阑尾炎（AA）伴“马蹄形”阑尾。
立即进行了探索性腹腔镜手术干预。
我们发现右下腹有一个不均匀图像，部分为液性，大小约16×9毫米，周围脂肪有炎症重塑。放射学检查结论为怀疑复杂性AA。最后，病理报告显示为急性化脓性阑尾炎伴腹膜反应。
马蹄形阑尾罕见。综合患者症状、放射学检查、超声及CT扫描结果，怀疑为急性阑尾炎。通过探索性腹腔镜检查及脓液微生物分析进一步诊断，患者经急诊手术及抗生素治疗后成功治愈。
