title: [Appendix vermiformis duplex--a rare surprise].
abstract: Duplication of the vermiform appendix is extremely rare. It is found in only 1/25.000 patients (0.004%) operated on for acute appendicitis. A 60-year-old male patient was hospitalized for a peridiverticular sigmoid abscess without signs of a free abdominal perforation and an abscess cavity in the small pelvis. A Hartmann's resection and an appendectomy (the vermiform appendix was part of the abscess wall) were performed. The pathology report described an external appendicitis. After 3 months, the intestine was successfully reanastomosed. During mobilisation of the coecum, a second retrocoecal vermiform appendix was surprisingly found. Because of signs of a chronic appendicitis a second resection was performed. Although the diagnosis of an appendix duplex is a rarity, surgeons should be aware of the possibility, especially when clinical signs and symptoms point to appendicitis, although at laparotomy the appendix looks normal. A routine exploration for a second appendix is definitely not indicated because of the rarity and the increased complication rate.
authors.affiliation: Chirurgische Abteilung, Kaiser-Franz-Josef-Spital, Sozialmedizinisches Zentrum Süd, Wien, Osterreich. sobhian19@yahoo.com
authors.forename: Babak
authors.initials: B
authors.lastname: Sobhian
authors.forename: Margit
authors.initials: M
authors.lastname: Mostegel
authors.forename: Claudia
authors.initials: C
authors.lastname: Kunc
authors.forename: Josef
authors.initials: J
authors.lastname: Karner
mesh_terms: D001064:Appendicitis / Q000175:diagnosis / Q000517:prevention & control* / Q000601:surgery*; D001065:Appendix / Q000002:abnormalities* / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D035583:Rare Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome