Clinical features and risk factors for appendiceal diverticulitis: a comparative study with acute appendicitis

Area of Science:

• Gastroenterology
• Pathology
• Surgical Oncology

Background:

• Appendiceal diverticulitis (AD) and acute appendicitis (AA) present with similar clinical symptoms but have distinct pathological characteristics.
• Differentiating AD from AA is crucial for appropriate clinical management and understanding disease-specific outcomes.

Purpose of the Study:

• To compare the clinical features of AD and AA.
• To identify risk factors that distinguish AD from AA.

Main Methods:

• Retrospective analysis of 854 patients who underwent appendectomy with a preoperative diagnosis of AD or AA.
• Categorization based on histopathological findings.
• Comparison of clinical factors including demographics, white blood cell count, eosinophil count, and mean corpuscular volume.

Main Results:

• AD was more prevalent in older, taller, and heavier males compared to AA.
• Multivariate analysis identified male sex, white blood cell count < 13.5 × 10^3/μL, eosinophil count ≥ 0.4%, and mean corpuscular volume ≥ 91.6 fL as significant differentiating factors.
• Pathological AD was an independent risk factor for abscess and/or perforation.

Conclusions:

• Appendiceal diverticulitis is associated with older age, a robust physique, and a higher risk of complications like abscess or perforation.
• Preoperative factors including male sex, specific white blood cell, eosinophil, and mean corpuscular volume levels can aid in distinguishing AD from AA, complementing imaging modalities.