When the Ileum Mimics Appendicitis: A Case of Uncomplicated Ileal Diverticulitis

Although colonic and duodenal diverticulosis is common, ileal diverticular disease is rare. The pathophysiology of ileal diverticula is poorly understood, but the most widely accepted hypothesis currently suggests abnormalities in the myenteric plexus or smooth muscle, high intraluminal pressure, and intestinal dyskinesia. Diagnosis is often delayed and difficult because the clinical presentation is nonspecific, and it is mainly imaging that allows the diagnosis to be established and guided. In the event of complications such as perforation, it can be life-threatening because of delays in diagnosis and treatment. We present an interesting case of ileal diverticulitis that posed a diagnostic and treatment challenge. A 76-year-old man presented to the emergency department with severe pain in the right iliac fossa that had been developing for 5 days. Once diagnosed, ileal diverticulitis must be managed according to the same therapeutic principles as sigmoid diverticulitis, as was the case for our patient. A misdiagnosis, with low prevalence and nonspecific symptoms, can lead to errors or delays in treatment. Our case shows the importance of having an accurate diagnosis of acute gastrointestinal pathologies before beginning treatment.