A case report on appendicular diverticulitis: Eluding traditional diagnosis

Int J Surg Case Rep. 2024 Apr:117:109563. doi: 10.1016/j.ijscr.2024.109563. Epub 2024 Mar 19.

Abstract

Introduction and importance: Diverticula of the vermiform appendix are rare entities. Although the pathogenesis and natural course of appendiceal diverticulitis (AD) are different from acute appendicitis, AD is treated like acute appendicitis because of similar clinical manifestations and low incidence.

Case presentation: We describe cases of two male patients of different ages who respectively underwent elective laparoscopic appendectomy and an emergent laparoscopic appendectomy in a multi-speciality hospital in Kerala, India. Both of them had acute appendicitis, as confirmed by imaging and laboratory testing. Subsequent histopathological examination revealed AD.

Clinical discussion: AD is an uncommon but potentially more serious form of appendiceal disease that can mimic acute appendicitis or malignancy. The first patient mimicked a malignancy with the mass presentation, while the second case presented like appendicitis. Unlike colonic diverticula, AD diverticula are typically not detectable by imaging or colonoscopy, which poses a diagnostic challenge.

Conclusion: In patients who present with lower abdominal pain or who may have appendicitis, AD should be considered as a differential diagnosis.

Keywords: Acute appendicitis; Acute diverticulitis; Appendectomy; Case report; Histopathology; Right iliac fossa pain.

Publication types

  • Case Reports