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World J Clin Cases. 2014 Aug 16;2(8):391-4. doi: 10.12998/wjcc.v2.i8.391.

Appendicitis in double cecal appendix: Case report.

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José Roberto Alves, Department of Integrated Medicine, University Hospital Onofre Lopes, Federal University of Rio Grande do Norte, 59012-300 Natal - Rio Grande do Norte, Brazil.


Double cecal appendix is a rare anatomical variation. Approximately 100 cases have been reported worldwide. It is usually diagnosed incidentally during emergency appendectomies due to inflammatory processes in the cecal appendix.


male, white, 36 years old, obese, presenting with pain in the lower abdomen for 24 h followed by nausea, vomiting and mild fever. He was subjected to additional tests, with the leukogram showing leukocytosis and abdominal ultrasonography depicting cecal appendix with thickened wall, locally associated with small quantities of liquid and intestinal loop obstruction. He underwent laparotomy, revealing acute appendicitis. Another intestinal loop obstruction was identified next to the ileum, leading to recognizing another cecal appendix after local dissection. Double appendectomy and segmental iliectomy were performed although not needed. Results of the anatomopathological examination of the surgical samples showed acute inflammation in the two cecal appendices. So, performing a routine retroperitoneal release and a complete cecum evaluation during such surgical procedures is recommended and suggested due to the possibility of not identifying a second cecal appendix.


Anatomic variation; Appendectomy; Appendicitis; Appendix; General surgery

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