Transverse colon diverticulitis mimicking acute appendicitis

BMJ Case Rep. 2024 Jan 31;17(1):e254703. doi: 10.1136/bcr-2023-254703.

Abstract

Diverticulitis in a solitary transverse colon diverticulum is uncommon, with only a handful of cases documented in the literature. There are various clinical manifestations of the disease, which make clinical and radiological diagnosis rather challenging. Herein, we present a case of a premenopausal female patient in her late 40s who presented to the emergency department, complaining of right lower quadrant abdominal pain, nausea, anorexia and fever. Following clinical, biochemical and radiological tests, the patient was prepared for surgical operation, with the presumed diagnosis of acute appendicitis. An appendicectomy was planned via a McBurney incision. Notably, no inflammation of the appendix was discovered. However, on further exploration, an inflammatory mass was identified in the transverse colon, which was subsequently excised and sent for histological examination. The histology results confirmed the presence of a ruptured solitary transverse colon diverticulum, accompanied by an adjacent mesenteric abscess. The patient's postoperative recovery was uneventful.

Keywords: general surgery; radiology.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Appendicitis* / complications
  • Appendicitis* / diagnosis
  • Appendicitis* / surgery
  • Appendix* / pathology
  • Colon, Transverse* / diagnostic imaging
  • Colon, Transverse* / surgery
  • Diagnosis, Differential
  • Diverticulitis* / complications
  • Diverticulitis, Colonic* / diagnostic imaging
  • Diverticulitis, Colonic* / surgery
  • Diverticulum, Colon* / complications
  • Female
  • Humans