Prevalence and clinical significance of appendiceal diverticulosis: An 11-year retrospective study

Appendiceal diverticulosis is a rare and often underdiagnosed entity with significant clinical implications. Limited data are available regarding its incidence, clinicopathological features, and optimal management strategies.

We retrospectively reviewed 6836 appendectomy specimens at our institution between January 2013 and December 2024. Cases diagnosed with appendiceal diverticulosis were identified, and their demographic, clinical, radiological, and pathological data were analyzed. The incidence, presentation, complications, and association with neoplasms were assessed.

Nineteen cases (0.27%) of appendiceal diverticulosis were identified, with a male predominance (68.4%) and a mean age of 49.7 ± 16.8 years. Preoperative diagnosis of AD was challenging; ultrasonography and computed tomography often failed to differentiate AD from conventional appendicitis. The perforation rate in AD cases was 26.3%, significantly higher than typical appendicitis. Neoplastic lesions were observed in 10.5% of AD specimens, although no malignancies were detected during the follow-up period. All patients underwent appendectomy, including those with incidentally discovered AD.

Appendiceal diverticulosis is a rare but clinically significant condition associated with increased risk of perforation and potential neoplastic transformation. Early surgical intervention is recommended for all cases, including incidental findings, to prevent complications. Our findings contribute to the limited body of literature on AD and highlight the importance of routine histopathological examination of appendectomy specimens.