Appendiceal Diverticulosis: A Clinicopathological Analysis of 12 Cases

Abstract

Purpose : Perforation occurs more often with appendiceal diverticulosis than with acute appendicitis ; thus, confirming a diagnosis of appendiceal diverticulosis is critical. We compared the clinicopathological features of 12 appendiceal diverticulosis cases (3 confirmed preoperatively) and 321 acute appendicitis cases (excluding catarrhal) and investigated the pathological features specific to appendiceal diverticulosis. Methods : Over a 7.5-year period, 12 of 392 patients with appendiceal disease were diagnosed with appendiceal diverticulosis (3 confirmed preoperatively). Findings from physical examination, abdominal ultrasonography and/or computed tomography, surgery, and histopathology were statistically analyzed. Results : Onset age was significantly later for appendiceal diverticulosis than for acute appendicitis (p = 0.0176) (average, 54.3 years). Perforation occurred more frequently with appendiceal diverticulosis (p < 0.001). There were no significant gender differences. Moreover, 11 patients had appendiceal diverticulitis. The average preoperative white blood cell count and C-reactive protein levels were 11929/µL and 7.15 mg/dL, respectively. Appendectomy (6 cases), partial cecal resection (4), and ileocecal resection (2) were performed. Pseudodiverticula were Received : May 29, 2013/Accepted : June 8, 2013 Correspondence to : Takefumi Yoshida Department of Surgery, Social Insurance Tagawa Hospital, 10-18 Kamihonmachi, Tagawa City, Fukuoka 826-8585, Japan confirmed histopathologically in all cases (mesenteric, 10 ; bilatera l, 2). Six patients suffered perforations. The average number of diverticula was 2.5. Conclusions : Excision is recommended when appendiceal diverticulosis is suspected or the presence of acute appendicitis is unclear.