An Indian female presenting with appendicular diverticulitis: a case report and review of the literature
© Halder and Khan; licensee Cases Network Ltd. licensee BioMed Central Ltd. 2009
Received: 31 May 2009
Accepted: 8 August 2009
Published: 9 September 2009
A 29-year-old Indian female patient presented clinically as a case of acute appendicitis. Peroperative finding showed inflamed diverticula of an appendix without perforation. Macroscopically, the rest of the appendix appeared normal. Histopathological examination confirmed appendicular diverticulitis in a noninflamed appendix. The vermiform appendix can rarely be a site of development of diverticula which may be inflamed or noninflamed, with or without appendicitis. Appendicular diverticulosis can present either with chronic abdominal pain or with acute abdominal pain as acute appendicitis. Thay may be completely asymptomatic. It can be associated with various complications resulting increased morbidities and mortalities.
The vermiform appendix can rarely be a site of development of diverticula which may be found inflamed or non-inflamed, with or without appendicitis . Appendicular diveticulitis was first described in 1893 by Kelynac . Although it can be a source of chronic abdominal pain , it commonly presents with acute right iliac fossa pain. Occasionally, barium enema can pick up diverticulosis of appendix. Although computed tomogram , and ultrasonogram have diagnosed appendicular diverticulitis, it is commonly diagnosed peroperatively. As it can be associated with various life threatening complications like perforation, peritonitis, abscess, pseudomyxoma peritonei, the treatment should be appendicectomy.
Clinical subtypes of appendicular diverticulosis
Appendicular diverticulum can be diagnosed by barium enema. This may make removal of an appendix with diverticulosis appropriate, when found incidentally during surgery or upon barium enema.
We conclude that inflammatory complications of the appendiceal diverticula, although they may mimic acute appendicitis, are quite distinct clinical entities. Appendicular diverticulosis, when inflamed, carries an earlier and higher rate of perforation. So, even if diagnosed incidentally, appendectomy is justified for appendicular diverticulosis.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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