Appendiceal Diverticulitis Presenting with Clinical Features of Acute Appendicitis: Case Report and Literature Review

Samih Hwala, Charbel Aoun, Imad El Hajj, Alexandre Malek, Toufic Saber, Said Farhat, Antoine El Asmar, Jacqueline Saad and Mansour El Khoury

Department of General Surgery, Saint Georges Hospital University Medical Center, University of Balamand, Lebanon
Department of Gastroenterology, Saint Georges Hospital University Medical Center, University of Balamand, Lebanon

^*Correspondance to: Charbel Aoun 

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Abstract:

Introduction: Appendiceal diverticulitis is a rare entity that can mimic acute appendicitis. Differentiation between the two pathologies is necessary due to the high risk of perforation in the case of diverticulitis.
Case Report: A case of appendiceal diverticulitis presenting with clinical features of acute appendicitis. Laboratory results showed elevated inflammatory markers, and Computed Tomography (CT) scan showed uncomplicated acute appendicitis. Laparoscopic appendectomy was done, however macroscopic examination showed inflamed diverticulum. Pathohistological analysis displayed an early appendicular diverticulitis.
Discussion: We evidenced type 1 appendiceal diverticular disease according to Phillips et al. classification. Diagnosis is based on clinical evaluation, and imaging suggestive of diverticulitis. Appendectomy is the treatment of choice. It can be performed with laparoscopy or laparotomy without any delay. Meticulous examination of abdominal cavity and thorough histological examination of the entire removed appendix are essential due to the higher association with malignancy.
Conclusion: Acute appendiceal diverticulitis is a rare disease. Its incidence, risk of perforation and bleeding are not well known comparing to the diverticular disease of the colon. Appendectomy is done even in the case of incidental finding of appendiceal diverticula in asymptomatic patients to avoid the high risk of perforation.

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Cite the Article:

Hwala S, Aoun C, El Hajj I, Malek A, Saber T, Farhat S, et al. Appendiceal Diverticulitis Presenting with Clinical Features of Acute Appendicitis: Case Report and Literature Review. World J Surg Surgical Res. 2019; 2: 1137.