Background
Duplication of the appendix is a rare anomaly. To date, about 100 such cases have been recorded in the English literature, and although two cases are described as horseshoe appendices, none referred the unique configuration with a single tip presented in this case report.
Case report
A 20-year-old woman presented with a two-day history of right iliac fossa pain. An appendicectomy was performed along with a lymph node excisional biopsy. Histological examination revealed a horseshoe double appendix and an incidental high grade B-cell non-Hodgkin lymphoma.
Conclusions
Despite its rarity, failure to recognize appendiceal duplication may have serious clinical and medico-legal consequences. As in our case, this anomaly may be an incidental finding, highlighting the need for increased awareness of the condition, especially amongst junior doctors. A lymphoma may present with a non-specific abdominal pain. Our case presented as an acute appendicitis which prompted us to proceed with surgical exploration. Based on our findings and the review of the relative literature, we propose a modification of the existing classification of appendicial duplication.