Abstract
Acute appendicitis is a common surgical emergency, whereas appendix duplication is an exceptionally rare congenital anomaly, occurring in 0.004–0.009% of cases and described fewer than 100 times in the literature. Failure to identify this anomaly may lead to recurrent appendicitis and serious complications. The study describes a rare case of double appendicitis and emphasize the importance of thorough intraoperative exploration to prevent diagnostic errors and complications. A 25-year-old woman was admitted with right iliac pain, vomiting, weakness, leukocytosis, elevated C-reactive protein, and free pelvic fluid on ultrasound. Emergency laparoscopy revealed two appendices: a normal descending appendix (10.0cmby 1.0 cm) and a second appendix (7.0cmby 2.0 cm) with gangrenous perforation and purulent discharge. Both appendices were removed laparoscopically. The postoperative course was uneventful, and the patient was discharged after targeted antibiotic therapy for Pseudomonas aeruginosa. This unique case emphasizes the need for careful intraoperative exploration of the cecal region during appendectomy. Recognition of appendix duplication is essential to prevent missed pathology, recurrent symptoms, and medicolegal consequences.