Vidović Stipe, Čekić Nenad, Šuvak Ivica, Ugljarević Mladen, Pogorelić Zenon
Department of Surgery, National Memorial Hospital Vukovar, 32 000 Vukovar, Croatia.
Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
Clin Pract. 2025 Mar 13;15(3):60. doi: 10.3390/clinpract15030060.
: Appendiceal diverticulitis is a rare and poorly understood condition of the appendix. The diagnosis of appendiceal diverticulitis is challenging due to its rarity and a clinical presentation that often mimics other ileocecal disorders. Unlike acute appendicitis, appendiceal diverticulitis may be associated with a higher risk of perforation, increased mortality, and a potential link to neoplasms. However, further research is necessary to enhance our understanding of its epidemiology, risk factors, clinical presentation, and outcomes. : A 53-year-old male presented to the emergency department with right lower abdominal pain. On physical examination, tenderness was noted in the right lower quadrant, without rebound tenderness or muscle guarding. Laboratory tests revealed leukocytosis and elevated C-reactive protein (CRP) levels. Ultrasonographic imaging of the ileocecal region suggested acute appendicitis, leading to a decision for surgical intervention. Laparoscopic exploration revealed multiple cylindrical, red, and edematous herniations, up to 4 mm in size, on the surface of the vermiform appendix. An appendectomy was performed. Histopathological examination confirmed appendiceal diverticulitis with surrounding peridiverticulitis. The surgery and early postoperative course were uneventful. : The study included 5 retrospective studies and 30 case reports, analyzing a total of 112 patients with appendiceal diverticulitis. Of these, 65.5% were male and 34.5% were female, with a median age of 49 years (IQR: 39-59). The most commonly reported clinical findings included pain in the right iliac fossa or right lower abdominal quadrant (56.5%), nausea (18.9%), vomiting (9.8%), rebound tenderness (24.6%), fever (15.6%), leukocytosis (25.4%), and elevated C-reactive protein levels (16.4%). Diagnosis was confirmed histopathologically in 86.9% of the cases via computed tomography imaging in 4.1% and ultrasonography in 1.6%. A histopathological analysis identified five neoplasms (4.1%), including two sessile serrated adenomas, two neuroendocrine carcinoids, and one mucinous tumor. Appendectomy was the treatment of choice, with no intraoperative or postoperative complications recorded and no mortality reported. The median hospital stay was 6.8 days (IQR: 3.0-6.8). : Appendiceal diverticulitis should be considered as a differential diagnosis in patients presenting with symptoms resembling acute appendicitis. Early diagnosis and treatment are essential to reduce morbidity and mortality. Appendectomy is a safe and effective treatment approach for appendiceal diverticulitis.
阑尾憩室炎是一种罕见且了解较少的阑尾疾病。由于其罕见性以及临床表现常与其他回盲部疾病相似，阑尾憩室炎的诊断具有挑战性。与急性阑尾炎不同，阑尾憩室炎可能与更高的穿孔风险、死亡率增加以及与肿瘤的潜在联系有关。然而，需要进一步研究以加深我们对其流行病学、危险因素、临床表现和结局的理解。
一名53岁男性因右下腹痛就诊于急诊科。体格检查发现右下腹压痛，无反跳痛或肌紧张。实验室检查显示白细胞增多和C反应蛋白（CRP）水平升高。回盲部超声成像提示急性阑尾炎，遂决定进行手术干预。腹腔镜探查发现阑尾表面有多个圆柱形、红色且水肿的疝出物，大小达4毫米。进行了阑尾切除术。组织病理学检查证实为阑尾憩室炎伴周围憩室周炎。手术及术后早期过程顺利。
该研究纳入了5项回顾性研究和30例病例报告，共分析了112例阑尾憩室炎患者。其中，65.5%为男性，34.5%为女性，中位年龄为49岁（四分位间距：39 - 59岁）。最常报告的临床发现包括右髂窝或右下腹象限疼痛（56.5%）、恶心（18.9%）、呕吐（9.8%）、反跳痛（24.6%）、发热（15.6%）、白细胞增多（25.4%）以及C反应蛋白水平升高（16.4%）。86.9%的病例通过组织病理学确诊，4.1%通过计算机断层扫描成像确诊，1.6%通过超声检查确诊。组织病理学分析发现5例肿瘤（4.1%），包括2例无蒂锯齿状腺瘤、2例神经内分泌类癌和1例黏液性肿瘤。阑尾切除术是首选治疗方法，未记录术中或术后并发症，也未报告死亡病例。中位住院时间为6.8天（四分位间距：3.0 - 6.8天）。
对于出现类似急性阑尾炎症状的患者，应将阑尾憩室炎视为鉴别诊断之一。早期诊断和治疗对于降低发病率和死亡率至关重要。阑尾切除术是治疗阑尾憩室炎安全有效的方法。
