Clinical Implications of Diverticular Disease of the Appendix. Experience Over the Past 10 Years

Marcacuzco, Alberto; Manrique, Alejandro; Calvo, Jorge; Loinaz, Carmelo; Justo, Iago; Caso, Óscar; Cambra, F.; Fakih, N.; Sanabria, R.; Jiménez-Romero, Luis Carlos

doi:10.1016/j.cireng.2014.05.015

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Rare complications of DDA include intestinal obstruction, hemorrhage, and fistula formation [42,43]. Some authors advocate prophylactic appendicectomy when DDA is incidentally diagnosed during an unrelated surgical procedure in order to reduce complications or subsequent development of appendiceal neoplasms [7]. We did not study the colonoscopy database for lower gastrointestinal bleeding patients and hence were unable to comment association of DDA with bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective Danish study including 4,413 appendix specimens from 2001-2010, Kallenbach et al [6] reported that 39 patients had DDA and 4 (10.3%) patients had colorectal neoplasm. In a Spanish study reporting on 7,044 appendicectomies, Marcacuzco et al [7] have shown a 46% association with perforation and 7.1% concomitant neoplasm incidence. They discuss the role of prophylactic appendicectomy in asymptomatic patients with an incidental diagnosis of DDA.…”

Section: Introductionmentioning

confidence: 95%

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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: Introductionmentioning

confidence: 95%

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Chia

Chan

Shelat

2020

GE Port J Gastroenterol

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“…The disease may present acutely due to the inflammatory process, similar to that of acute appendicitis. In other cases, it may present as a recurring, chronic pain or it may be completely asymptomatic [ 10 ]. The four cases described were seen in a range of age groups without any significant co-morbidity.…”

Section: Discussionmentioning

confidence: 99%

Diverticulitis and Diverticulosis of the Appendix: A Case Series

Lesi¹,

Probert²,

Iqbal³

et al. 2022

Cureus

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IntroductionDiverticula of the appendix is a rare entity, may be complicated by inflammation/infection, and clinically mimics acute appendicitis. The reported associated risk factors include male gender, Hirschprung's disease, cystic fibrosis and adult age, where some reports claim that they are also associated with an increased risk of appendiceal malignancy. Imaging has a place in pre-operative diagnosis, however, most of the cases were diagnosed during a pathological examination after surgery. They are associated with a higher rate of perforation (more than four times compared with classical acute appendicitis). In this review, we present a case series of five patients diagnosed with diverticulitis and one with diverticulosis of the appendix that were managed at a single centre. Our aim is to explore the common clinical, radiological, and intra-operative findings associated with this disease as well as the outcome of management. Materials and methodsA total number of six cases of diverticular disease of the appendix diagnosed and managed at Basildon University hospital in the period between 2016 and 2020 were studied. The demographic details and clinical data including presenting symptoms, laboratory results, radiological characteristics, intraoperative findings and histopathological features were analysed. ResultsThe study group included four males and two females, with an age range of 20-84 years. The most common presenting clinical symptoms were right iliac fossa abdominal pain, nausea, anorexia, and diarrhoea. Half of the cases showed a thickened appendix in the pre-operative CT scan. An inflamed or perforated appendix was seen in five cases as well as inflammation of the diverticula. ConclusionAppendiceal diverticulitis is an uncommon pathology that imitates acute appendicitis, and appendicectomy is the standard treatment. Prophylactic appendicectomy is recommended for non-inflamed diverticula -this is due to the potential risk of inflammation, perforation, and the risk of developing an appendiceal neoplasm.

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“…Many mechanisms have been proposed for the pathogenesis of acquired appendiceal diverticulum; including luminal obstruction and/or increased intraluminal pressure and uncoordinated muscular contractions that cause herniation of mucosa through the appendiceal wall (3,4). A relatively high risk of developing primary appendiceal neoplasms such as neuroendocrine tumors, adenomas and adenocarcinomas in the patients with appendiceal diverticulosis is reported in the literature (3,5).…”

Section: Discussionmentioning

confidence: 99%

“…Appendiceal diverticulum may be congenital or acquired and is infrequently encountered with reported incidence rates of 0.014% to 2.2% (3)(4)(5). They are often asymptomatic but when diverticulitis or perforation develops, it may clinically mimic acute abdomen of acute suppurative appendicitis.…”

Section: Introductionmentioning

confidence: 99%

Apendiks vermiformiste divertiküler hastalık ve endometriozis: Özgün bir kombinasyon

et al. 2019

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Endometriosis is characterized by the presence of endometrial glands and stroma outside the uterine cavity. Appendiceal endometriosis, which is very rare, may have nonspecific presentation such as chronic pelvic pain, but sometimes it can masquerade clinically as acute appendicitis. Also appendiceal diverticulum may be congenital or acquired and is an infrequently encountered lesion. They are often asymptomatic but when diverticulitis or perforation develops, it may clinically mimic acute abdomen of acute suppurative appendicitis. Herein we report a case with a unique combination of appendiceal diverticulosis and endometriosis in a 39-year-old woman that was diagnosed preoperatively as acute appendicitis.

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Clinical Implications of Diverticular Disease of the Appendix. Experience Over the Past 10 Years

Cited by 6 publications

References 19 publications

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Diverticulitis and Diverticulosis of the Appendix: A Case Series

Apendiks vermiformiste divertiküler hastalık ve endometriozis: Özgün bir kombinasyon

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