Persistence of appendix after total colectomy: An unexpected surgical finding. Case report

INTRODUCTION: Total colectomy is a major surgical procedure that involves the resection of the entire colon, including the cecum and, consequently, the appendix. However, in this case, an intact and vascularized appendix was identified during an exploratory laparotomy three years after the colectomy. This finding is exceptional, as no previous cases have been reported in the literature. The present case report explores possible explanations that could justify this situation. CONCLUSION: The surgical finding presented is unusual, and although various anatomical and technical explanations were explored, none provided a definitive answer. Other possibilities, such as errors in documentation or deliberate surgical decisions, were also evaluated but failed to fully justify what occurred. A relevant aspect was the viability of the tissue despite an inadequate blood supply, which challenges normal physiological expectations. This report highlights the importance of conducting thorough surgical explorations and maintaining accurate documentation in complex procedures, especially in emergency situations, to prevent inadvertent omissions and improve clinical outcomes. Keywords: Appendix, Total colectomy, Unusual anatomical finding, Ectopic, Duplication, Remnant.