A rare case of duplicated appendix presenting as perforated appendicitis

Anomalies of the appendix have been reported mostly in adults as an incidental finding during surgery. The incidence of duplication of the vermiform appendix is reported to be 0.004% and <10 cases of appendicitis have been reported in duplicated appendix. This is a case report of an 18-year-old male who was diagnosed to have perforated appendicitis by imaging, and on open surgical exploration was found to have appendiceal duplication. Histopathological examination of both specimens revealed a perforated necrotic first appendix and an acutely inflamed second appendix. Surgeons must always bear in mind a high degree of suspicion regarding the possibility of duplicated appendices in all cases that are clinically and radiologically suspected to have acute appendicitis or perforated appendicitis. A thorough intraoperative examination of caecum is mandatory to avoid missing the duplication; thus, preventing post-operative complications and medicolegal issues.