Colloid nodular goitre associated with hemiagenesis of the thyroid gland.

Hemiagenesis of the thyroid gland is a rare congenital abnormality usually left unnoticed without associated thyroid disorders. The most common congenital anomaly of the thyroid gland is a thyroglossal cyst, followed by ectopic thyroid tissue and thyroid dysgenesis, which may be agenesis or hemiagenesis. Preoperative underevaluation of the thyroid hemiagenesis (THA) associated with other thyroid disorders may cause intraoperative difficulty in identifying the gland and difficulty in preservation or even identification of major neurovascular structures during neck exploration. We report a patient who presented to us with right-sided neck swelling. On further evaluation and neck exploration, the patient was diagnosed with THA of the left lobe with right colloid goitre.

An Unusual Tale of Two Appendices in a Case of Acute Appendicitis: One Gangrenous, One Inflamed.

Appendicectomy is one of the most common surgeries performed worldwide. The incidence of acute appendicitis is higher among adolescents and young adults. Though various positions of the appendix, such as retrocecal, pelvic, subcecal, pre- or post-ileal, and their clinical implications have been well established, appendiceal anomalies like duplication or triplication of the appendix are yet to receive attention due to their very low incidence. We report an incidental finding of a duplicated appendix in a 19-year-old girl who presented with features of acute appendicitis. What makes this case report an interesting learning point for young surgeons is the identification of a perforated appendix with gangrene at the tip, along with an inflamed duplicated appendix. This report alerts us to the need for a thorough intraoperative inspection, to look for possible anatomical abnormalities, and to take the right management decisions to avoid unnecessary re-explorations. While operating a patient with features of acute appendicitis, a failure to identify a duplicated appendix is comparable to abandoning an inflamed appendix in-situ. Such instances not only increase the morbidity due to complications like the formation of pelvic abscesses, wound dehiscence, and surgical site infection, but also cause mortality.