Appendiceal diverticulitis shortly after a performed laparoscopic sigma resection

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Diverticulosis of the vermiform appendix is an uncommon condition.
• It typically presents with mild, intermittent, or chronic abdominal pain.

Observation:

• A 52-year-old patient presented with lower abdominal pain, initially suspected as sigmoid diverticulitis.
• Computed tomography (CT) revealed complicated sigmoid diverticulitis and an atypical appendix.
• The patient later developed recurrent right-sided abdominal pain, with CT showing an increasingly thickened appendix.

Findings:

• Laparoscopic sigmoid resection was performed, with the appendix appearing normal intraoperatively.
• Pathology confirmed a small diverticulum of the appendix and a gallbladder adenoma.
• A subsequent laparoscopic appendectomy and cholecystectomy were performed.

Implications:

• Diverticulitis of the appendix, though rare, should be considered in the differential diagnosis of right lower abdominal pain.
• Appendectomy may be indicated even in cases with a macroscopically normal-appearing appendix.
• This case highlights the importance of thorough pathological examination and considering appendiceal pathology in recurrent abdominal pain.