Duplex Vermiform Appendix Left Behind after Laparoscopic Appendectomy: A Case Report

Abstract

Abstract Background: Duplex appendix, a rare form of vermiform appendix, is seldom encountered. These anomalies are often found incidentally during surgery for other pathologies or occasionally due to their own involvement. Case presentation: Here, we present a case of a 19-year-old male who initially presented to the hospital with right lower quadrant abdominal pain accompanied by nausea, vomiting, and anorexia. Physical examination revealed tenderness at the McBurney's point and rebound tenderness along with visible guarding. Blood counts showed leukocytosis. Abdominal ultrasound demonstrated an enlarged and thickened appendix. The patient underwent laparoscopic appendectomy, and then, 4 months later, he returned to the hospital with pain in the right lower quadrant, tenderness, and rebound tenderness. A diagnostic laparoscopic surgery was performed, revealing another appendix in the retrocecal area. Ultimately, the patient underwent a repeat appendectomy and was discharged from the hospital without complications after one day. Conclusions: Acute appendicitis should not be ruled out definitively in a patient with typical clinical manifestations, especially in those with a history of laparoscopic appendectomy. Complete exploration of the cecum during surgery is the only reliable option to rule out appendix anomalies and prevent future medical complications.