1 INTRODUCTION
Congenital anomalies of the appendix are extremely rare. The reported
incidence is 0.004%. They include agenesis, duplication, and anatomical
variation related to length and position. Appendix duplicity is the most
common type, of which type B2 is the most common variant and commonly
associated with acute appendicitis. A total of 141 cases of duplicity
were reported.1 However, appendicitis of the double
appendix was reported in less than 15 cases.2According to the modified Cave-Wallbridge classification (Figure 1),
type B2 is the most common variant reported in the literature.
Routine preoperative imaging modalities, CT scans, and abdominal
abdominal ultrasound did not reveal duplicity.3 The
failure to identify duplicity in appendectomy can leads to significant
uncertainty in assessing the right lower quadrant pain if the second
appendix (missed appendix) is inflamed in the future. For this
uncertinity of the diagnosis, appendicitis of missed appendix may leads
to increased morbidity and mortality and serious medico-legal
consequences.
In this clinical case report, we present a rare case of double appendix
in a patient with acute appendicitis discovered incidentally during the
surgery. The surgery was done in Orotta referral hospital, Asmara,
Eritrea.