Appendiceal agenesis in a 3-year-old boy presenting with suspected acute appendicitis: a case report
- 1Department of Pediatric Surgery, the Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
- 2Chengde Nursing Vocational College, Chengde, Hebei, China
- 3Department of Hematology Laboratory, the Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
Abstract
Appendiceal agenesis is a rare congenital gastrointestinal anomaly, usually discovered unexpectedly during surgery for suspected acute appendicitis. It cannot be diagnosed pre-operatively by clinical, laboratory or imaging findings, and final confirmation requires thorough surgical inspection of the ileocecal region. We report a 3-year-old boy with 38-hour intermittent abdominal pain, bilious vomiting and fever suggestive of acute appendicitis. Pre-operative CT failed to visualize the appendix but showed pericecal inflammation and enlarged mesenteric lymph nodes. Laparoscopy combined with limited open laparotomy confirmed Collins Type-III appendiceal agenesis (complete absence of the appendix with an intact caecum), accompanied by localized peritonitis and intra-abdominal adhesions. Mesenteric lymph node biopsy revealed reactive lymphadenopathy, excluding granulomatous or neoplastic lesions. The child had an uneventful postoperative recovery and was discharged in satisfactory condition. This case highlights that appendiceal agenesis should be included in the differential diagnosis when the appendix cannot be located intra-operatively, and surgeons should adhere to standardized exploration protocols before establishing this diagnosis.
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BibTeX
@article{yang2026appendiceal,
title = {{Appendiceal agenesis in a 3-year-old boy presenting with suspected acute appendicitis: a case report}},
author = {Xiaofeng Yang and Lijun Wang and Dan Zhang and Xinhong Yang},
journal = {Frontiers in Pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.2012352},
url = {https://doi.org/10.3389/fped.2026.2012352},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Appendiceal agenesis in a 3-year-old boy presenting with suspected acute appendicitis: a case report
AU - Xiaofeng Yang
AU - Lijun Wang
AU - Dan Zhang
AU - Xinhong Yang
PY - 2026
DA - 2026/10/21
JO - Frontiers in Pediatrics
DO - 10.3389/fped.2026.2012352
UR - https://doi.org/10.3389/fped.2026.2012352
AB - Appendiceal agenesis is a rare congenital gastrointestinal anomaly, usually discovered unexpectedly during surgery for suspected acute appendicitis. It cannot be diagnosed pre-operatively by clinical, laboratory or imaging findings, and final confirmation requires thorough surgical inspection of the ileocecal region. We report a 3-year-old boy with 38-hour intermittent abdominal pain, bilious vomiting and fever suggestive of acute appendicitis. Pre-operative CT failed to visualize the appendix but showed pericecal inflammation and enlarged mesenteric lymph nodes. Laparoscopy combined with limited open laparotomy confirmed Collins Type-III appendiceal agenesis (complete absence of the appendix with an intact caecum), accompanied by localized peritonitis and intra-abdominal adhesions. Mesenteric lymph node biopsy revealed reactive lymphadenopathy, excluding granulomatous or neoplastic lesions. The child had an uneventful postoperative recovery and was discharged in satisfactory condition. This case highlights that appendiceal agenesis should be included in the differential diagnosis when the appendix cannot be located intra-operatively, and surgeons should adhere to standardized exploration protocols before establishing this diagnosis.
SN - 2296-2360
ER -