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Updated: May 9, 2026
05:07
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Ischaemic diverticular disease may mimic acute appendicitis
1Department of Cabarrus Family Medicine, Carolinas Medical Center-Northeast, Concord, North Carolina, USA. kara.gallagher@carolinashealthcare.org
BMJ Case Reports
|July 30, 2013
Summary
A rare case of ischemic cecal diverticulitis mimicking appendicitis highlights the importance of considering alternative diagnoses. Laparoscopic ileocecectomy successfully treated the condition, demonstrating effective surgical intervention for cecal pathology.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Diverticulosis and irritable bowel syndrome are common gastrointestinal conditions.
- Appendicitis is a frequent cause of acute abdominal pain, particularly in the right lower quadrant.
Observation:
- An 81-year-old male presented with acute right lower quadrant pain, nausea, anorexia, and chills.
- Physical examination revealed tenderness at McBurney's point, suggestive of appendicitis.
- Initial diagnostic workup, including a normal white blood cell count and abdominal CT scan, did not reveal appendiceal or other significant pathology.
Findings:
- Laparoscopy identified a normal appendix but revealed a large ischemic diverticulum in the cecum.
- Histopathological examination of the resected specimen confirmed hemorrhage, inflammation, edema, and full-thickness necrosis of the cecal wall.
- The patient underwent successful laparoscopic ileocecectomy.
Implications:
- This case underscores that ischemic cecal diverticulitis can present atypically, mimicking appendicitis.
- Advanced imaging may not always detect cecal diverticular complications.
- Prompt surgical intervention, such as ileocecectomy, is crucial for managing severe cecal diverticular disease.
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