Diverticulosis and diverticulitis of the appendix

Area of Science:

• Gastroenterology
• Pathology
• Surgical Oncology

Background:

• Appendiceal diverticulosis, the presence of outpouchings in the appendix, is a rare condition.
• Most cases involve acquired pseudodiverticula, with true congenital diverticula being exceptionally rare.

Purpose of the Study:

• To review the clinical and pathological characteristics of appendiceal diverticulosis.
• To highlight its association with appendiceal neoplasms and pseudomyxoma peritonei.
• To emphasize the importance of prophylactic appendicectomy.

Main Methods:

• Review of pathological findings in appendiceal specimens.
• Analysis of clinical presentations and outcomes.
• Correlation with radiological and intraoperative findings.

Main Results:

• Appendiceal diverticulosis is typically an incidental finding, often asymptomatic.
• Symptomatic cases usually present as acute or chronic diverticulitis, with or without appendicitis, predominantly in adult males.
• Appendiceal diverticulitis shows rapid progression to perforation and higher mortality compared to acute appendicitis.
• A significant association exists between appendiceal diverticulosis and appendiceal neoplasms, including mucinous tumors.

Conclusions:

• Appendiceal diverticulitis is a distinct clinical entity requiring consideration in differential diagnoses, especially for chronic abdominal pain in adult males.
• Meticulous examination of appendicectomy specimens is essential for identifying diverticulosis and associated neoplasms.
• Prophylactic appendicectomy is recommended upon discovery to prevent complications and detect coexisting tumors.