A Case of Duplication of the Intestine with Acute Appendicitis

Abstract

A 22-year-old woman presented to our hospital with right lower abdominal pain. She had no fever and mild tenderness in the right lower abdomen, but no guarding. Blood tests showed a mildly elevated inflammatory reaction. Abdominal computed tomography showed an enlarged appendix and the dirty fat sign. Conservative treatment for suspected acute appendicitis was planned, but surgery was performed because her abdominal symptoms worsened. On laparoscopy, an enlarged appendix was found, and an appendicectomy was performed. However, pus was found in the mesentery of the ileum about 50 cm from the ileum end, and a small laparotomy showed duplicated ileum. A partial resection of the small intestine was also performed. Pathologically, acute appendicitis and perforation of the duplicated ileum were diagnosed. There were no ectopic components and no tumors. The patient was discharged from the hospital on the seventh postoperative day. In this case, it was thought that the patient developed appendicitis first, and the perforation was caused by increased intestinal pressure in the duplicated intestinal tract. A case of intestinal duplication with acute appendicitis, which is rare, is reported.