title: Acute appendicitis in a duplicated appendix.
abstract: BACKGROUND
  Double appendix represents an extremely rare and commonly "missed" diagnosis, often with life threatening consequences.
  
  
  METHODS
  In this case report we present an interesting case of operative treatment of acute appendicitis in a doubled vermiform appendix stemming operative pitfalls. A 23-year-old female was admitted to the emergency room department complaining of diffuse abdominal pain, nausea, and vomiting over the past 36h. As soon as the diagnosis of acute appendicitis was established a laparotomy via a McBurney incision was decided. Intraoperative findings included the presence of mild quantity of free fluid and surprisingly a thin non-inflamed appendiceal process. It was the preoperative ultrasound findings suggestive of acute appendicitis that dictated a more thorough investigation of the lower abdomen that led to the discovery of a second retrocecal inflamed appendix. Formal appendectomy was then performed for both processes. The patient had an uneventful recovery and was discharged on the fourth postoperative day.
  
  
  CONCLUSIONS
  Double appendix represents a challenging clinical scenario in cases of right lower quadrant pain.
  
  
  CONCLUSIONS
  Life threatening consequences with legal extensions can arise from the incomplete removal of both stumps.
authors.affiliation: Department of General Surgery, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Christodoulidis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Symeonidis
authors.forename: Michail
authors.initials: M
authors.lastname: Spyridakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Koukoulis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Manolakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Triantafylidis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tepetes