Presentation
No previous medical/surgical history. 12 hours continuous RIF abdominal pain. Physical exam revealed localized RLQ rebound tenderness. Referred for a CT to confirm the clinical suspicion of appendicitis.
Patient Data
There is a blind-ending, tubular structure with thick, contrast enhancing walls adjacent to and actually connected to the distal ileum. The structure is surrounded by stranding of intra-abdominal fat. Note the moderate dilatation of proximal small bowel secondary to the inflammatory process in the distal ileum.
In this sagittal series you can readily identify the normal appendix, which in this patient has a retrocecal course.
Case Discussion
The patient was treated conservatively with oral antibiotics. Follow-up CT after one month showed total resolution of inflammatory changes around the diverticulum and no sign of small bowel obstruction.
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