Year 2021 Vol. 29 No 3

CASE REPORTS

R.V. UKRAINETS 1, 2, YU.S. KORNEVA 1, 2, A.V. SERGEEV 1, 3

PARTIAL DUPLICATION OF VERMIFORM APPENDIX AS A CAUSE OF THE APPENDICEAL INFILTRATE

Smolensk State Medical University 1,
Smolensk Regional Institute of Pathology 2,
Emergency Clinical Hospital 3, Smolensk,
The Russian Federation

The appendix anomalies are extremely rare malformations. Preoperative diagnosis of appendiceal duplication is often difficult and usually discovered incidentally during surgery for appendicitis. A clinical case of the development of chronic residual appendicitis in a 32-year-old woman with the abnormality of the vermiform appendix identified duplicity, type A according to the Cave-Wallbridge classification is described. During the first hospitalization, the patient was treated conservatively with a diagnosis of a dense appendiceal infiltrate; later, a planned appendectomy was performed. A duplication of the vermiform appendix type A was revealed during the examination of the removed appendix. Histopathological examination detected the underdevelopment of the wall of the accessory vermiform appendix - a complete absence of the outer longitudinal layer of the muscular membrane. The abnormally thin wall of the accessory appendix, as well as the related with it hypoperistalsis provoked the onset of chronic inflammation in the wall, which easily spread to the periappendiceal adipose tissue with the formation of a dense appendiceal infiltrate, which required surgical intervention. Thus, a rare clinical case of duplication of the vermiform appendix type A with forming of appendiceal infiltrate, associated with abnomality of muscular tissue, shown by the surgical findings and corroborated by pathology samples of intestinal tissue has been presented.

Keywords: congenital malformation, duplication of the vermiform appendix, appendiceal infiltrate, chronic appendicitis, intestinal visceral myopathy
p. 376-381 of the original issue
References
  1. Panda SK, Prasad C, Tirkey R, Rajesh V, Mishra J, Dora RK. Unusual association of Meckels diverticulum with double appendix A rare finding. Int J Surg Case Rep. 2014;5(11):879-81. doi: 10.1016/j.ijscr.2014.09.009
  2. Drino E, Radnić D, Kotjelnikov B, Aksamija G. Rare anomalies in the development of the appendix. Acta Chir Iugosl. 1991;38(1):103-11.
  3. Travis JR, Weppner JL, Paugh JC 2nd. Duplex vermiform appendix: case report of a ruptured second appendix. J Pediatr Surg. 2008 Sep;43(9):1726-28. doi: 10.1016/j.jpedsurg.2008.04.023
  4. Dubhashi SP, Dubhashi UP, Kumar H, Patil C. Double appendix. Indian J Surg. 2015 Dec;77(Suppl 3):1389-90. doi: 10.1007/s12262-013-1014-1
  5. Nazir S, Bulanov A, Ilyas MI, Jabbour II, Griffith L. Duplicate appendix with acute ruptured appendicitis: a case report. Int Surg. 2015 Apr;100(4):662-65. doi: 10.9738/INTSURG-D-14-00150.1
  6. Alves JR, Maranhão IG, de Oliveira PV. Appendicitis in double cecal appendix: Case report. World J Clin Cases. 2014 Aug 16;2(8):391-94. doi: 10.12998/wjcc.v2.i8.391
  7. Christodoulidis G, Symeonidis D, Spyridakis M, Koukoulis G, Manolakis A, Triantafylidis G, Tepetes K. Acute appendicitis in a duplicated appendix. Int J Surg Case Rep. 2012;3(11):559-62. Published online 2012 Aug 14. doi: 10.1016/j.ijscr.2012.08.004
  8. Tutcu Şahin S, Erhan Y, Aydede H. Double acute appendicitis in appendical duplication. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):83-85. doi: 10.5505/tjtes.2013.80557
  9. Lombardi L, Bruder E, Pio L, Nozza P, Thai E, Lerone M, Del Rossi C, Mattioli G, Silini EM, Paraboschi I, Martucciello G. Diagnostic criteria of pediatric intestinal myopathies. J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):383-86. doi: 10.1097/MPG.0000000000001727
  10. Stephens D, Arensman R, Pillai S, Alagiozian-Angelova V. Congenital absence of intestinal smooth muscle: a case report and review of the literature. J Pediatr Surg. 2009 Nov;44(11):2211-15. doi: 10.1016/j.jpedsurg.2009.08.008
  11. Panasyuk AI, Shurygina IA, Byrgazov RO, Grigoryev YG. Chronic appendicitis. definition, diagnosing and treatment. Russian Sklifosovsky Journal Emergency Medical Care. 2016;(3):74-78. https://www.jnmp.ru/jour/article/view/298/0 (In Russ.)
  12. Shurygina IA, Dremina NN, Panasjuk AI, Kanja OV, Shurygin MG. Chronic appendicitis morphological diagnosis. Sib Med Zhurn (Irkutsk). 2018;153(2):17-19. http://smj.ismu.baikal.ru/index.php/osn/article/view/289 (In Russ.)
  13. Kirillova IA, Kravcova GI, Kruchinskij GV. Teratologija cheloveka. Moscow, RF: Medicina; 1991. 480 p. (In Russ.)
Address for correspondence:
214019, Russian Federation,
Smolensk, Krupskaia Str., 28,
Emergency Clinical Hospital, Surgery Unit;
tel. +7(4812)242000, additional number 280,
e-mail: sergeev.alex@yahoo.com
tel. +375 29 651-35-69,
Sergeev Alexey V.
Information about the authors:
Ukrainets Roman V., Pathologist, the Department of Clinical Pathology No2, Smolensk Regional Institute of Pathology, Assistant of the Department of Pathological Anatomy, Smolensk State Medical University, Smolensk, Russian Federation.
https://orcid.org/0000-0002-0590-1399
Korneva Yulia S., PhD, Associate Professor of the Department of Pathological Anatomy, Smolensk State Medical University, Pathologist, the Department of Clinical Pathology No2, Smolensk Regional Institute of Pathology Smolensk, Russian Federation.
https://orcid.org/0000-0002-8080-904X
Sergeev Alexey V., PhD, Associate Professor of the Department of Hospital Surgery, Smolensk State Medical University, Head of the Surgical Unit of the Emergency Clinical Hospital, Smolensk, Russian Federation.
https://orcid.org/0000-0002-0437-9551
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