Partial appendiceal duplication with double bases converging into a single body and tip: a first reported case from Nepal.

INTRODUCTION

Anomalies of the appendix are very rare, occurring only in 0.004% to 0.009% of appendectomy cases. Among these, appendiceal duplication represents a particularly unusual finding. We are presenting a case of an appendicular lump with an appendix having two bases converging into one body and tip.

CASE PRESENTATION: A 50 year-old female presented to a tertiary care center in Nepal with chief complaints of abdominal pain for 3 days and vomiting for 3 days. The abdominal pain was acute in onset, sharp, and aching, located in the right iliac region. Ultrasonography revealed that the appendix was dilated at the region of the tip and body (approximately 9-10 mm) with a normal-appearing base. The patient was planned for an interval open appendectomy for an appendicular lump. Intraoperatively, the appendix was found to have two luminal bases with a single tip and body.

DISCUSSION: Partial duplication of the appendix with an inverted Y-shaped configuration is an exceptionally rare anatomical anomaly. Such duplications are mostly discovered incidentally during surgery. Their clinical significance lies in their potential to cause diagnostic confusion and incomplete management if unrecognized.

CONCLUSION

This case highlights the importance of careful intraoperative examination of the cecal region during appendectomy procedures to avoid missed diagnoses, repeated surgeries, and potential medicolegal implications.