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Case report
Simultaneous acute appendicitis in identical twin boys
  1. Mark L Kovler and
  2. Eric B Jelin
  1. Division of General Pediatric Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Dr Mark L Kovler, mkovler1{at}


Acute appendicitis is one of the most common causes of abdominal pain in children but remains a diagnostic challenge, and insight into the aetiology of the condition is lacking. A case of simultaneous acute appendicitis in monozygotic twin boys is reported here. Familial aggregation in acute appendicitis has been described, but the underlying causes for this are not well understood. The patients reported here were both genetically identical and lived a mostly identical lifestyle. Their simultaneous presentation would be exceedingly rare if explained entirely by chance, suggesting a role for both genetic and environmental influences. Increased knowledge of this occurrence may assist in prompt diagnosis and reporting on the incidence and timing of appendicitis in monozygotic twins could better elucidate the genetic and environmental factors that predispose to this disease.

  • paediatric surgery
  • gastrointestinal surgery
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  • Contributors Both authors provided comprehensive manuscript drafting. The first author, MLK, was responsible for literature review, primary drafting of the manuscript. The senior author, EBJ, was the primary surgeon for the patients reported, assisted with editing of the manuscript and review of the patients records for preparation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.

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