Difficulty in the differential diagnosis of ileal diverticulitis and colonic diverticulitis

Abstract

A 77-year-old man with abdominal pain was referred to our hospital. He was diagnosed with colonic diverticulitis by abdominal computed tomography (CT) examination. However, he suffered a relapse of inflammatory reaction after treatment. Abdominal CT findings revealed abscess formation around the ileocecal region. During surgery, it was observed that peritoneal abscess cavity was surrounded by sigmoid colon, ileum, and ileocecal mesentery. The cavity communicated with the intra-mesenteric abscess cavity in the ileocecum. The abscess was drained and ileocecal resection was performed. Pathological examination revealed ileal diverticulitis with penetration to mesentery and peritoneal abscess formation. We should consider ileal diverticulitis in the differential diagnosis of acute abdomen with nonspecific abdominal pain.