Duplicated Vermiform Appendix (Type B2) in Complicated Acute Appendicitis: A Pediatric Case Report.

Appendiceal duplication is a rare congenital anomaly with important diagnostic and surgical implications, particularly when it remains undetected during appendectomy. We present the case of a 16-year-old male with an eight-day history of progressive abdominal pain that evolved into generalized peritonitis. Laboratory evaluation revealed leukocytosis (25,530/mm³), neutrophilia (83%), and elevated C-reactive protein (277.2 mg/L). Abdominal ultrasound demonstrated findings consistent with complicated appendicitis. Exploratory laparotomy identified two gangrenous appendices with independent bases and mesoappendices, corresponding to type B2 duplication. Both structures were resected using Pouchet's technique. Histopathological examination confirmed acute suppurative, necro-hemorrhagic, perforated appendicitis in both specimens. The postoperative course was favorable, and the patient was discharged on the second postoperative day. This case highlights the clinical relevance of meticulous intraoperative inspection of the cecum and retrocecal space to detect unusual anatomical variants, ensuring complete surgical management and preventing recurrence or postoperative complications.