Appendiceal diverticulitis: diagnosis and differentiation from usual acute appendicitis using computed tomography.

Area of Science:

• Radiology
• Gastroenterology
• Surgical pathology

Background:

• Appendiceal diverticulitis is a condition involving inflammation of diverticula in the appendix.
• Distinguishing appendiceal diverticulitis from typical acute appendicitis is crucial for appropriate patient management.

Purpose of the Study:

• To characterize the computed tomographic (CT) findings associated with appendiceal diverticulitis.
• To compare CT findings and clinical presentations of appendiceal diverticulitis with those of acute appendicitis.

Main Methods:

• Retrospective review of CT and clinical data from 23 patients with appendiceal diverticulitis.
• Comparison with CT and clinical data from 23 patients with acute appendicitis.

Main Results:

• CT identified inflamed diverticula in 80% of appendiceal diverticulitis cases, typically as small, enhancing cystic outpouchings in the distal appendix.
• Appendicoliths were less common in appendiceal diverticulitis (5%) compared to acute appendicitis (48%).
• Patients with appendiceal diverticulitis were older (median 45 years) than those with acute appendicitis (median 31 years).

Conclusions:

• Computed tomography is effective in differentiating appendiceal diverticulitis from acute appendicitis.
• Visualization of inflamed diverticula on CT is a key distinguishing feature.