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.