Bifid vermiform appendix: a case report

Curr Surg. May-Jun 2006;63(3):176-8. doi: 10.1016/j.cursur.2006.02.001.


Introduction: Appendiceal anomalies are extremely rare: they have a reported incidence of between 0.004% and 0.009% of appendectomy specimens. The authors report a case of a patient who was found to have 2 appendices at emergency laparotomy, review the classification system used, and discuss the potential clinical pitfalls of similar cases.

Case report: A 23-year-old man was admitted as an emergency with abdominal pain and vomiting. The operative finding was of a bifid appendix. One appendix was grossly gangrenous and lacked a mesoappendix, whereas the other had a mesoappendix and appeared macroscopically normal. The appendices shared a common base that arose from the cecum in the typical anatomical position. No other intra-abdominal malformations were present at inspection during laparotomy. Histology confirmed features of gangrenous appendicitis. His postoperative recovery was uneventful, and he was discharged after 4 days.

Conclusion: Although rare, it is important for several reasons that surgeons are aware of the potential anatomical anomalies and malpositions of the vermiform appendix: first, a missed second appendix may result in serious clinical and medico-legal consequences; second, a double appendix can be confused with other intra-abdominal conditions; and finally, they can be associated with other congenital abnormalities.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Appendicitis / pathology*
  • Appendicitis / surgery
  • Appendix / abnormalities*
  • Appendix / pathology
  • Congenital Abnormalities / classification
  • Gangrene
  • Humans
  • Male