Abstract
Of a total of 546 cases undergoing an appendectomy at the hospital in a recent 7-year period, five cases of appendiceal diverticulosis were encountered. Their ages ranged from 29 to 75 years, with an average of 49.6. The disease was more common in men, four out of the five patients. A mean time from the onset to surgery was about 1.5 days. Peritoneal signs were positive in four patients, and the white blood cell count increased in all patients. The swollen appendix was visualized on ultrasonography in three and on CT in one patient. All patients underwent an appendectomy with a preoperative diagnosis of acute appendicitis. As for the number of diverticula, three patients had multiple and two had a solitary lesion. The sites of lesions were the head part of the appendix in three, center in one, and root in one; the mesentery side of the appendix in three and contralateral in two. All three patients who had inflammation in the diverticula themselves had their lesions on the mesentery side, with perforation. Retention of ascites was noted in two patients. Histopathologically all patients had false diverticula which lack muscular layer in the diverticular wall.
It is difficult to diagnose appendiceal diverticulosis before surgery. When the disease is detected accidentally on gastrointestinal series or other procedures, strict follow-up of the patient's clinical course is required. And if inflammation in diverticulum is suspected, prompt surgical resection is recommended because of its high probability of perforation.
