Ur Rehman Mutee, Paulus Felik, Chew Min Hoe
Department of General Surgery. Sengkang Hospital, 378 Alexandra Road, 159964, Singapore.
Department of Pathology, Sengkang Hospital, Singapore.
Int J Surg Case Rep. 2017;38:23-25. doi: 10.1016/j.ijscr.2017.06.064. Epub 2017 Jul 10.
Appendicular diverticula and associated diverticulitis is a rare disease. Patients present commonly with symptoms of acute appendicitis and require laparoscopic or open surgery. Diagnosis is usually made only on histology. Here, we present a rare case of acute diverticulitis of the appendix.
A 33-year old gentleman presented with right iliac fossa pain of 3 days duration. On admission, appendicitis was diagnosed on Computerized Tomography (CT) scan and laparoscopic appendicectomy was subsequently performed. Intra-operative findings were unremarkable and recovery was uneventful. Histopathology however revealed diverticulitis of appendix with acellular mucin.
Acute diverticulitis of the appendix is an exceptionally rare condition and reported in 0.004%-2% of appendicectomies. It presents usually when complicated with perforation and bleeding. There is however a strong association with certain malignancies such as mucinous neoplasm, carcinoid and Pseudomyxoma peritoneii. Radiological proven appendicular diverticulum requires early intervention due to higher chance of diverticulitis related complication. Surgeons should be aware about this rare disease and may consider elective surgery in view of potential risk of complications and malignancy.
We concluded that because of strong malignant association, it would be recommended that all appendix specimens should inspect during and after surgery and concurrent examination of peritoneal cavity is recommended.
阑尾憩室及相关憩室炎是一种罕见疾病。患者通常表现为急性阑尾炎症状，需要进行腹腔镜手术或开放手术。通常仅通过组织学检查才能确诊。在此，我们报告一例罕见的阑尾急性憩室炎病例。
一名33岁男性因持续3天的右下腹疼痛就诊。入院时，计算机断层扫描（CT）诊断为阑尾炎，随后进行了腹腔镜阑尾切除术。术中发现无异常，恢复顺利。然而，组织病理学显示阑尾憩室炎伴无细胞黏液。
阑尾急性憩室炎是一种极为罕见的疾病，在阑尾切除术中的报告发生率为0.004% - 2%。它通常在合并穿孔和出血时出现。然而，它与某些恶性肿瘤如黏液性肿瘤、类癌和腹膜假黏液瘤有很强的关联。经放射学证实的阑尾憩室由于发生憩室炎相关并发症的可能性较高，需要早期干预。外科医生应了解这种罕见疾病，并鉴于并发症和恶性肿瘤的潜在风险，可考虑进行择期手术。
我们得出结论，由于与恶性肿瘤有很强的关联，建议在手术期间和术后检查所有阑尾标本，并建议同时检查腹腔。
