Therapeutics and Clinical Risk Management (Oct 2018)

One type of duplex appendix: horseshoe appendix

  • Liu J,
  • Dong C,
  • Wang H,
  • Sun D,
  • Liang R,
  • Gao Z,
  • Wang L

Journal volume & issue
Vol. Volume 14
pp. 1987 – 1992

Abstract

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Jin Liu,1,* Chengyong Dong,2,* Haibo Wang,2 Deguang Sun,2 Rui Liang,2 Zhenming Gao,2 Liming Wang1,2 1General Surgery, Center for New Material and New Precision Technology of Cancer Therapy, Dalian Medical University, Dalian, Liaoning, China; 2Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China *These authors contributed equally to this work Abstract: A horseshoe appendix is a subtype of duplex appendix, in which the appendix is shaped like a circle that may lead to an internal hernia and result in intestinal necrosis. This subtype is extremely rare, with only 13 cases reported worldwide to date, and easily triggers a series of medico-legal consequences due to the neglect of another infection base of the appendix. We describe a 22-year-old man who presented with a 3-day history of fever and was diagnosed with pneumonia. After receiving antibiotics for 3 days in the Department of Pneumology, he was found to have a periappendiceal abscess. He underwent appendectomy after 3 days of conservative treatment failure in the Department of General Surgery. During the operation, we found that he had a horseshoe appendix with the two bases forming a circle, each communicating with the cecum. We provide a review of 13 cases presented in the literature, with a discussion of the clinical features, diagnosis, and surgical approach of the horseshoe appendix to make the general surgeon get a clear concept of this type of appendicitis. Keywords: appendix malformation, hernia, intestinal obstruction, embryonic development, appendix neoplasm

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