A Rare Cause of Right Lower Quadrant Abdominal Pain: Uncomplicated Ileal Diverticulitis

Ileal diverticulitis is a rare cause of abdominal pain. Even though small intestine diverticulosis is relatively rare, resulting pathologies including diverticulitis are still clinically relevant in both an inpatient and outpatient setting often presenting with varying levels of severity. Most reported cases of ileal diverticulitis are complicated and managed surgically. In contrast to these more complicated presentations, this report illustrates an uncomplicated case of ileal diverticulitis presenting with right lower quadrant abdominal pain and leukocytosis treated successfully conservatively with medical management. Although rare, uncomplicated ileal diverticulitis is clinically pertinent and should be included in the differential diagnosis of abdominal pain as this disease presentation can cause symptoms that are commonly associated with more prevalent pathologies such as acute appendicitis. Thus, these presentations are often mistaken for other more common and/or emergent pathologies depending on the region of the symptomatic small bowel diverticulitis. In this case report, the patient's presentation initially mimicked mild atypical appendicitis and was thus managed with this diagnosis in mind without the need for more extensive treatment including surgery. There are currently fewer case reports available that display a patient with uncomplicated ileal diverticulitis and the difference in the presentation and management of these patients compared to more severe cases. Physicians should have a heightened awareness of this disease process to avoid delayed management or prevent/postpone complications. This lack of current awareness in part may be due to the less volatile presentation associated with uncomplicated ileal diverticulitis and thus delayed patient presentation, as was seen with this case. However, it is important to note that as with any patient's care, proper treatment must be individualized, especially given the variable nature of patient presentations with ileal diverticulitis. All in all, one hope is that improving clinician awareness of uncomplicated cases of ileal diverticulitis such as this patient presentation will result in improved outcomes for a multitude of future patients.