Acute Appendicitis or Appendiceal Diverticulitis? A Case Report and Systematic Literature Review

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Appendiceal diverticulitis is an uncommon gastrointestinal condition with diagnostic difficulties due to overlapping symptoms with ileocecal disorders.
• It carries a higher risk of perforation and mortality compared to acute appendicitis, with a potential association with neoplasms.
• Limited understanding necessitates further research into its epidemiology, risk factors, clinical presentation, and outcomes.

Purpose of the Study:

• To investigate the clinical presentation, diagnosis, and management of appendiceal diverticulitis.
• To review existing literature and present a case report to enhance understanding of this rare condition.
• To highlight the importance of considering appendiceal diverticulitis in differential diagnoses for ileocecal pain.

Main Methods:

• A case report of a 53-year-old male with right lower abdominal pain is presented.
• Literature review encompassing 5 retrospective studies and 30 case reports, analyzing 112 patients.
• Diagnostic methods included physical examination, laboratory tests (leukocytosis, CRP), ultrasonography, and histopathological examination.

Main Results:

• The case patient underwent successful laparoscopic appendectomy confirmed histopathologically.
• Literature review of 112 patients showed a median age of 49, with 65.5% males; common symptoms included right lower quadrant pain (56.5%).
• Histopathology confirmed appendiceal diverticulitis in 86.9% of cases; 4.1% had associated neoplasms. Appendectomy was universally successful with no mortality.

Conclusions:

• Appendiceal diverticulitis requires consideration in the differential diagnosis of acute appendicitis.
• Prompt diagnosis and treatment, primarily appendectomy, are vital for mitigating morbidity and mortality.
• Appendectomy demonstrates safety and efficacy in managing appendiceal diverticulitis.