A Case of Appendiceal Diverticulitis with True Appendiceal Diverticulosis Resected by Laparoscopic Surgery

Abstract

A 70-year-old man presented to our hospital with a history of vomiting, diarrhea, and right lower abdominal pain. Abdominal contrast-enhanced CT showed an enlarged appendix and findings consistent with appendiceal diverticulitis. Considering the risk of progression of the severity of the condition because of inflammation associated with diverticular perforation, we decided to perform laparoscopic appendectomy in a semi-urgent manner. Multiple diverticula of various sizes were found on the appendix, and the root of the appendix was dissected using a linear stapler. Postoperative histopathological examination revealed multiple true diverticula with inflammatory cell infiltration, mainly lymphocytes and plasma cells in the wall of the diverticulum and appendix. We made the diagnosis of appendiceal diverticulitis with true appendiceal diverticula. Appendiceal diverticulosis is a relatively rare condition, with the diverticula being pseudodiverticula in most cases; true diverticula are extremely rare. Considering the high risk of serious complications, such as perforation and abscess formation, and the need to differentiate from appendiceal tumors, we should select an appropriate treatment plan, including identifying the surgical indications.