Abstract

Duplex cecal appendix is a rare anatomical variation. Approximately 100 cases of double cecal appendix have been described so far. Till now there is no report of duplex appendix serving as a lead point in a patient with intussusceptions. This case report presents the first case of such presentation for the first time. This 6 month old female child presented with vomiting and diarrhea of week duration. She was tachycaridic, tachypniec and febrile. On abdominal examination she had distended and tender abdomen with hyper tympanic sound on percussion. She was irritable and had a sunken eye ball. She had leaukocytosis (20.8 × 10³), hypokalemia (3.3 mmol/l) and hyponatremia (125 mmol/l). Abdominal ultrasounds were suggestive of intussusception. After stabilizing the patient we operated her for possible pre-operative diagnosis of SBO secondary to Intussusception. Intra-operatively it was an Ileocolocolic intussusception with duplex appendix as a leading point. We did resection and anastomosis. Post operatively she was transfused with two units of blood (20 ml/kg), given IV antibiotics, analgesics and followed with vital sign sheet (Table 1). She started PO feeding after 36 hours post operation and discharged on the 7th day improved. The case is extremely important for the study of this possible anatomical variation and its association with intussusceptions. It also serves as an input for future studies in the area. Moreover, its association with the presence of other anatomical variations such as intestinal, genitourinary and bone is important. And reporting such a rare case is very essential in the development of surgical practice.

Keywords: Duplex appendix; Intussusceptions; Cecum; Lead point; Resection and anastomosis; Ileocolocolic; Anatomic variation