Appendiceal diverticulitis

Case contributed by Alejandro Planas Callao
Diagnosis certain

Presentation

Right iliac fossa pain.

Patient Data

Age: 75 years
Gender: Female

Admission CT

ct

Enlarged appendix with multiple inflamed diverticulum.

Periappendiceal fluid laminae and fat stranding.

No other relevant findings.

Detail of axial section.

Annotated image

Red arrow: enlarged appendix with mural thickening.

Orange arrow: diverticula.

Pathology Report

Photo

Pathology report, which mainly reports on :

  • appendiceal diverticulosis with acute diverticulitis

  • low-grade appendiceal mucinous neoplasm (LAMN), pTis

Case Discussion

Appendiceal diverticulitis appears as inflammation of appendiceal diverticula, whose presence is often associated with small proximal appendiceal tumors 1.

Appendiceal diverticula is more common in young men (around 30 years of age) and diverticulitis presents with more insidious symptoms than classic acute appendicitis, which sometimes leads to a delay in diagnosis. It is 4 times more likely to perforate than common acute appendicitis 2.

Appendiceal diverticulitis is treated by appendectomy. Prophylactic appendectomy is also recommended due to the high risk of perforation in case of a future diverticulitis, and also to rule out a concomitant neoplasia (as in our case, which had a low-grade mucinous neoplasm).

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