Duplex appendix
Updates to Article Attributes
Duplex appendix is a rare anomaly of the appendix and is usually discovered incidentally during surgery for appendicitis.
Epidemiology
Duplication of the vermiform appendix is extremely rare. It is found in only 1 in 25,000 patients (incidence ~0.004%) operated on for acute appendicitis. Although duplication anomalies are uncommon, they have clinical and medicolegal significance.
ItA case is also reported that a case in which a child had two appendectomies performed twice in a 5 month period.
Classification
This classification was proposed by Wallbridge in 1963, and at the time of writing (July 2016) remains the most widely accepted classification.
The Cave-Wallbridge classification divides appendix duplications into three types:
- type A: single caecum with one normally localised appendix exhibiting partial duplication
-
type B: single caecum with two completely separate appendices and divided into two further subgroups
- type B1 (‘bird-like type’): two appendices located symmetrically on either side of the ileocaecal valve, resembling the normal arrangement in birds
- type B2 (‘taenia coli’ type): one appendix arises from the caecum at the usual site, and the second branches at varying distances along the lines of the taenia from the first
- type C: double caecum, each bearing its own appendix
Some authors have since described further types of complex multiplicity of the appendix. For example, "horseshoe appendix", "duplicated appendix and cecum"6, and "triple appendix" but these are often only diagnosed at surgery and not with imaging.
Pathology
Associations
When anomalies of the appendix are detected in childhood they are nearly always associated with severe intestinal, genitourinary or bony malformations, seen most often in conjunction with type B1 and C duplications.
Differential diagnosis
Possibilities to consider include:
-<p><strong>Duplex appendix</strong> is a rare anomaly of the <a href="/articles/appendix">appendix</a> and is usually discovered incidentally during surgery for <a href="/articles/appendicitis">appendicitis</a>.</p><h4>Epidemiology</h4><p>Duplication of the vermiform appendix is extremely rare. It is found in only 1 in 25,000 patients (incidence ~0.004%) operated on for acute appendicitis. Although duplication anomalies are uncommon they have clinical and medicolegal significance.</p><p>It is also reported that a case in which a child had appendectomies performed twice in a 5 month period.</p><h4>Classification</h4><p>This classification was proposed by Wallbridge in 1963, and at the time of writing (July 2016) remains the most widely accepted classification.</p><p>The <strong>Cave-Wallbridge classification</strong> divides appendix duplications into three types:</p><ul>- +<p><strong>Duplex appendix</strong> is a rare anomaly of the <a href="/articles/appendix">appendix</a> and is usually discovered incidentally during surgery for <a href="/articles/appendicitis">appendicitis</a>.</p><h4>Epidemiology</h4><p>Duplication of the vermiform appendix is extremely rare. It is found in only 1 in 25,000 patients (incidence ~0.004%) operated on for acute appendicitis. Although duplication anomalies are uncommon, they have clinical and medicolegal significance.</p><p>A case is also reported in which a child had two appendectomies performed in a 5 month period.</p><h4>Classification</h4><p>This classification was proposed by Wallbridge in 1963, and at the time of writing (July 2016) remains the most widely accepted classification.</p><p>The <strong>Cave-Wallbridge classification</strong> divides appendix duplications into three types:</p><ul>
-</ul><p>Some authors have since described further types of complex multiplicity of the appendix. For example, "horseshoe appendix" , "duplicated appendix and cecum"<sup>6</sup>, and "triple appendix" but these are often only diagnosed at surgery and not with imaging.</p><h4>Pathology</h4><h5>Associations</h5><p>When anomalies of the appendix are detected in childhood they are nearly always associated with severe intestinal, genitourinary or bony malformations, seen most often in conjunction with type B1 and C duplications.</p><h4>Differential diagnosis</h4><p>Possibilities to consider include:</p><ul>- +</ul><p>Some authors have since described further types of complex multiplicity of the appendix. For example, "horseshoe appendix", "duplicated appendix and cecum"<sup>6</sup>, and "triple appendix" but these are often only diagnosed at surgery and not with imaging.</p><h4>Pathology</h4><h5>Associations</h5><p>When anomalies of the appendix are detected in childhood they are nearly always associated with severe intestinal, genitourinary or bony malformations, seen most often in conjunction with type B1 and C duplications.</p><h4>Differential diagnosis</h4><p>Possibilities to consider include:</p><ul>
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