Evola Giuseppe, Caruso Giovambattista, Pulvirenti Elia, D'Angelo Maria, Reina Martina, Reina Giuseppe Angelo
General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95124 Catania, Italy.
General Surgery Department, Santissimo Salvatore Hospital (ASP Catania), Paternò, Catania, Italy.
Int J Surg Case Rep. 2023 Aug;109:108535. doi: 10.1016/j.ijscr.2023.108535. Epub 2023 Jul 28.
Appendiceal diverticulitis (AD) represents a rare cause of acute abdomen. Diagnosis of AD is a challenge because of its rarity and resemblance to other ileocecal diseases like as cecal diverticulitis (CD) and acute appendicitis (AA). Preoperative imaging can be useful to aid diagnosis. Surgery represents the correct treatment of AD.
A 48-year-old Caucasian male presented to the Emergency Department with a two-day history of right lower quadrant (RLQ) abdominal pain and fever. Physical examination revealed RLQ abdominal pain and rebound tenderness with muscle guarding. Laboratory tests reported high levels of C-reactive protein and neutrophilic leukocytosis. Abdominal computed tomography(CT) scan showed findings of AA and a thin-walled 5 mm appendiceal diverticulum. The patient underwent laparoscopic appendectomy. The postoperative course was uneventful, the patient was discharged on the 5th postoperative day in a stable condition. Gross anatomy confirmed the presence of appendiceal diverticulum in the distal appendix on the mesenteric border. Histopathological examination revealed an inflamed and perforated appendiceal pseudo-diverticulum with surrounding AA and peri-appendicitis.
Appendiceal diverticulosis is an uncommon entity, classified as congenital or acquired based on the number of appendiceal layers herniating through the normal wall. Two thirds of diverticula will develop acute or chronic diverticulitis that can lead to several complications some of which can be life-threatening.
AD is a rare surgical emergency and represents often an overlooked diagnosis. Early diagnosis and treatment are crucial for reducing morbidity and mortality Appendectomy represents a safe and appropriate treatment of AD.
阑尾憩室炎（AD）是急性腹痛的罕见病因。由于其罕见性以及与其他回盲部疾病如盲肠憩室炎（CD）和急性阑尾炎（AA）相似，AD的诊断具有挑战性。术前影像学检查有助于诊断。手术是AD的正确治疗方法。
一名48岁的白种男性因右下象限（RLQ）腹痛和发热两天就诊于急诊科。体格检查发现右下象限腹痛、反跳痛伴肌紧张。实验室检查报告C反应蛋白水平升高和中性粒细胞增多。腹部计算机断层扫描（CT）显示急性阑尾炎表现以及一个5毫米薄壁阑尾憩室。患者接受了腹腔镜阑尾切除术。术后过程顺利，患者于术后第5天病情稳定出院。大体解剖证实肠系膜缘远端阑尾存在阑尾憩室。组织病理学检查显示阑尾假性憩室发炎并穿孔，伴有周围急性阑尾炎和阑尾周炎。
阑尾憩室病是一种不常见的疾病，根据穿过正常肠壁的阑尾层数分为先天性或后天性。三分之二的憩室会发展为急性或慢性憩室炎，可导致多种并发症，其中一些可能危及生命。
AD是一种罕见的外科急症，常被漏诊。早期诊断和治疗对于降低发病率和死亡率至关重要。阑尾切除术是AD安全且合适的治疗方法。
