Ileocolic Atresia with Appendicular Duplication: A Case Report

INTRODUCTION: Intestinal atresias are rare entities, the incidence of ileocolic atresia is 1 in 5000 to 10,000 live births. The incidence of appendiceal duplication is 0.004% to 0.009% and is associated with other anomalies of the digestive and genitourinary tract. Less than 100 cases of Appendiceal Duplication have been reported since 1902. PRESENTATION OF CASE: Two-day-old male newborn born by caesarean section due to fetal distress, was referred for abdominal distension due to necrotizing enterocolitis, sepsis and probable syphilis. The physical examination found abdominal distension, the X-ray of the abdomen showed pneumoperitoneum, the associated lab work indicated leukocytosis, severe thrombocytopenia, high potassium. During surgery, a greenish and purulent fluid was found, dilated distal ileum with necrosis and a blind pouch: subseral cecal appendix with coprolite inside, collapsed colon, suppurated cecum with necrotized blind pouch with fibrin, the dilated distal ileum was resected with cecal appendix. The cecum and blind pouch are resected; an ileostomy and colostomy are performed with mucous fistula. The patient had infection by Klebsiella and pseudomonas, was discharged at one month of life and was transferred to a more specialized hospital for severe dehydration, the intestinal tract was restored without major complication. DISCUSSION: Ileocolic atresia are rare entities, appendix duplication also, which may be an incidental finding during surgery. It is important to have the surgery as soon as possible to avoid complications. CONCLUSION: This is an extremely rare pathology, the surgery should be performed immediately after diagnosis or suspicion of obstruction to prevent further complications.