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One type of duplex appendix: horseshoe appendix

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

Received 12 July 2018

Accepted for publication 3 September 2018

Published 12 October 2018 Volume 2018:14 Pages 1987—1992

DOI https://doi.org/10.2147/TCRM.S179929

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang


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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