Sonographic appearance of an appendiceal diverticulum

Abstract

The increasing use of sonography for evaluating acute abdomen has brought greater recognition of appendicular abnormalities. We present an incidental finding of an appendiceal diverticulum during a sonographic examination of a 4-year-old child with acute appendicitis. Abdominal sonography showed an enlarged, swollen appendix with a diameter of 1.1 cm and a small, fingerlike lateral projection approximately 2.0 cm from its tip. The specimen, resected during an appendectomy, was 5.5 cm long and 1.0 cm in diameter and had a 0.3-cm outpouching. Microscopic examination revealed a pseudodiverticulum composed of mucosa and muscularis mucosa.

Clinical characteristics of 12 cases of appendiceal diverticulitis: a comparison with 378 cases of acute appendicitis

“…Konen et al [12] presented a case in which an uninflamed appendiceal diverticulum was identified by sonography in a child. In contrast, Kyoung et al [13] reported that most cases of appendiceal diverticulitis can be differentiated from acute appendicitis on computed tomography by visualization of the inflamed diverticulum.…”

“…The mean length of hospital stay was 8.2 ± 5.1 days (range[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Diverticulosis of vermiform appendix: Incidence and report of 6 cases

“…The imaging modality of AD shows appendiceal swelling parallel to the degree of inflammation. [5] It is suggested that when complications such as diverticulitis, perforation, and abscess formation develop, acute appendicitis-like symptoms and signs emerge. Early diagnosis and appendectomy seems critical because perforation of AD and resultant peritonitis eventually occur.…”

A case report describing diverticulosis of the appendix presenting as acute appendicitis

“…While appendectomy is curative for both, it is important to distinguish DA from appendicitis as it is four times more likely to perforate and may be a sign of an underlying neoplasm​ [2]. Abdominal CT and sonography may aid in diagnosis, but their utility is highly technician and radiologist dependent [7]. Given these factors, DA remains a largely incidental finding without a clear diagnostic algorithm.…”