Appendiceal Diverticulitis Presenting as Acute Appendicitis and Diagnosed After Appendectomy.

Area of Science:

• Gastroenterology
• Pathology
• Surgical Oncology

Background:

• Diverticular disease of the appendix (DDA) is an uncommon appendiceal pathology.
• DDA often presents with symptoms similar to acute appendicitis, leading to diagnostic challenges.
• The rarity of DDA contributes to a limited understanding of its clinical and pathological features.

Purpose of the Study:

• To evaluate the incidence of DDA.
• To analyze the clinical and pathological characteristics of appendiceal diverticulitis diagnosed post-appendectomy.
• To assess the association between DDA and appendiceal neoplasms.

Main Methods:

• Retrospective analysis of 1586 patients who underwent appendectomy from January 2016 to January 2022.
• Inclusion of parameters such as age, gender, preoperative diagnosis, laboratory results, imaging, surgical technique, histopathology, and complications.
• Detailed histopathological examination of appendectomy specimens.

Main Results:

• Diverticular disease of the appendix was identified in 10 patients (0.63% incidence).
• The mean age of affected patients was 34.4 years, with a male to female ratio of 4:1.
• One case of low-grade appendiceal mucinous neoplasia was detected in a patient with DDA.

Conclusions:

• Appendiceal diverticulitis is a rare entity frequently misdiagnosed as acute appendicitis.
• DDA is often an incidental finding during postoperative histopathological examination.
• DDA is associated with an increased risk of appendiceal neoplasm, necessitating thorough specimen evaluation.