Retrospective study of 24 cases of acute appendiceal diverticulitis: CT findings and pathological correlations

Yardımcı, Aytül Hande; Bektaş, Ceyda Turan; Paşaoğlu, Esra; Kinaci, Erdem; Özer, Çiğdem; Sevinç, Mert Mahsuni; Mahmutoğlu, Abdullah Soydan; Kılıçkesmez, Özgür

doi:10.1007/s11604-017-0625-z

Cited by 19 publications

(24 citation statements)

References 12 publications

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“…It is not possible to derive conclusions about the clinical profile of DDA patients based on available literature. The reports on DDA either focus on imaging features or histopathology and lack clinical data [6, 29]. In a study including 1,329 patients with appendicectomy, Yardimci et al [29] included 28 patients with appendix diverticulitis and reported on imaging features but not on clinical presentation or perioperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The reports on DDA either focus on imaging features or histopathology and lack clinical data [6, 29]. In a study including 1,329 patients with appendicectomy, Yardimci et al [29] included 28 patients with appendix diverticulitis and reported on imaging features but not on clinical presentation or perioperative outcomes. In a study including 4,413 appendicectomy specimens, Kallenbach et al [6] included 39 patients with DDA and reported on histopathology details but not on clinical presentation or perioperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Chia

Chan

Shelat

2020

GE Port J Gastroenterol

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Introduction: Diverticular disease of the vermiform appendix (DDA) has an incidence of 0.004 to 2.1% in appendicectomy specimens. DDA is variably associated with perforation and malignancy. We report a single-center experience of DDA. The primary aim is to validate the association of DDA with complicated appendicitis or malignancy, and the secondary aim is to validate systemic inflammatory response syndrome (SIRS) criteria and quick Sepsis-related Organ Failure Assessment (qSOFA) scores. Methods: The histopathology reports of 2,305 appendicectomy specimens from January 2011 to December 2015 were reviewed. Acute appendicitis was found in 2,164 (93.9%) specimens. Histology of the remaining 141 (6.1%) patients revealed: normal appendix (n = 110), DDA (n = 22), endometriosis of appendix (n = 6), and an absent appendix (n = 3). Patient demographics, clinical profile, operative data, and perioperative outcomes of DDA patients are studied. Modified Alvarado score, Andersson score, SIRS criteria, and qSOFA scores were retrospectively calculated. Results: The incidence of DDA was 0.95%. Ten patients (45.5%) had diverticulitis. The mean age of DDA patients was 39.5 years (range 23–87), with male preponderance (n = 12, 54.5%). The median Modified Alvarado score was 8 (range 4–9), and the median Andersson score was 5 (range 2–8). Fourteen patients (63.6%) had SIRS, and none had a high qSOFA score. Eight patients (36.4%) had complicated appendicitis (perforation [n = 2] or abscess [n = 6]). Eleven (50%) patients underwent laparoscopic appendicectomy. There were three 30-day readmissions and no mortality. Conclusion: DDA is a distinct clinical pathology associated with complicated appendicitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Chia

Chan

Shelat

2020

GE Port J Gastroenterol

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“…erefore, correct diagnosis and urgent management with antibiotics and appendectomy are currently favoured with laparoscopy being the preferred approach [12,13]. In contrast to diverticulitis of the colon or small bowel, no large series demonstrating successful nonoperative management of appendiceal diverticulitis are available, and this is most likely due to the fact that appendicitis and appendiceal diverticulitis are difficult to distinguish on imaging [14]. Radiographic diagnosis of appendiceal diverticulosis/diverticulitis is difficult, but CT scan may identify an appendiceal diverticulum with the pericaecal fat showing increased density.…”

Section: Discussionmentioning

confidence: 99%

Appendiceal Diverticulitis in a Young Female Diagnosed on Pathology after Laparoscopic Appendectomy for Acute Appendicitis

Onafowokan

Khairat

Bonatti

2021

Case Reports in Medicine

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Background. Appendiceal diverticulitis is a rare cause of inflammation of the appendix, which may mimic acute appendicitis. Its diagnosis is often delayed, and its occurrence carries an increased risk of significant complications, such as perforation. Case Presentation. A 23-year-old woman presented with sudden onset, severe, right lower quadrant abdominal pain and nausea. Her WBC was elevated, and abdominal CT showed findings indicative of acute appendicitis with a 13 mm fluid-filled appendix and local stranding. During laparoscopic appendectomy, significant inflammation was found around the appendix with some mucous material around the tip. The appendix base was not involved, and an endoloop was used to secure the stump. No other intra-abdominal abnormalities were observed. The patient recovered uneventfully. Pathology showed no classic appendicitis but appendiceal diverticulitis with signs of perforation. Discussion. Appendiceal diverticulitis is a rare condition which cannot be distinguished from acute appendicits clinically and on imaging. Diagnosis may be established based on pathology such as in our case. Appendectomy is indicated in appendiceal diverticulitis, and an appendix diverticulum is incidentally found during surgery or other investigations. This is due to the increased risk of perforation and the reported development of malignant tumors, including the appendix carcinoid.

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“…Appendicular diverticulitis is a very rare cause of acute appendicitis during pathological examinations (0.004-2.1%) (9). Given the difficulty of preoperative diagnosis, appendicular diverticulitis is only revealed by postoperative histopathological examinations.…”

Section: Discussionmentioning

confidence: 99%

“…Although fecaliths and lymphoid hyperplasia are the most common causes of this clinicopathological condition, some rare conditions can result in appendix obstruction. Endometriosis (7,8), diverticulitis (9), foreign body obliteration (10), neurofibroma (4), enterobiasis (11), tuberculosis (12), amebiasis (12), actinomycosis (1,13), and schistosomiasis (12), as well as appendix malignancies such as neuroendocrine tumor (carcinoid) (1,14), hyperplastic polyp (15), mucocele (1,6), mucinous cystadenoma (2), adenocarcinoma (6), mucinous cystadenocarcinoma (1), gastrointestinal stromal tumor (2), and lymphoma (2), are known to cause acute appendicitis.…”

mentioning

confidence: 99%

Usual and Unusual Pathologies of Appendicitis: A Retrospective Analysis of 385 Patients

Yardımcı¹,

Uras²

2021

Acibadem Universitesi Saglik Bilimleri Dergisi

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Purpose: Appendectomy is the most common abdominal surgery performed worldwide. In this report, we evaluated the results of pathological examinations of acute appendicitis specimens. Methods:We performed a retrospective analysis of patients operated on for acute appendicitis at our surgical department from 2009 to 2017. Data on age, gender, and pathological diagnostic parameters were analyzed.Results: A total of 385 patients (168 women [43.6%] and 217 men [56.4%]), were classified into acute appendicitis (Group 1), normal appendix (Group 2), and unusual pathological findings (Group 3) groups. The patients undergoing appendectomy were mostly in the 21-30 (n = 136, 35.3%) and 31-40 years (n = 118, 30.6%) age groups. The negative appendectomy rate was 4.4% in Group 2, and the proportion of women (70.6%) was significantly higher in that group than the other groups (p <0.05). In total, 24 (6.2%) patients had unexpected findings. Among the appendix tumors (n = 12 [3.1%]) in our series, low-grade mucinous neoplasm (n = 6, 1.6%) was the most common, followed by a welldifferentiated neuroendocrine tumor (n = 3, 0.8%). Conclusion:Although unusual pathological findings are rare during appendectomy, all appendectomy specimens should be sent for routine histopathological examination. The abnormal incidental findings of 24 cases in this series had a significant impact on management. Patients with rare abnormalities should be treated according to the results of their pathological reports.

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Retrospective study of 24 cases of acute appendiceal diverticulitis: CT findings and pathological correlations

Cited by 19 publications

References 12 publications

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Appendiceal Diverticulitis in a Young Female Diagnosed on Pathology after Laparoscopic Appendectomy for Acute Appendicitis

Usual and Unusual Pathologies of Appendicitis: A Retrospective Analysis of 385 Patients

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