Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3921
Peer-review started: June 30, 2014
First decision: July 21, 2014
Revised: September 11, 2014
Accepted: October 20, 2014
Article in press: October 21, 2014
Published online: April 7, 2015
Processing time: 281 Days and 19 Hours
AIM: To study the clinical features and computed tomography (CT) findings of appendiceal diverticulitis vs acute appendicitis.
METHODS: We retrospectively reviewed the records of 451 patients who had undergone appendectomy in our institution from January 2007 to September 2012. Patient demographics, clinical features, pathological findings, and surgical outcomes were analyzed. We also compared preoperative CT images of 25 patients with appendiceal diverticulitis with those of 25 patients with acute appendicitis.
RESULTS: Among 451 patients, 44 (9.7%) were diagnosed to have appendiceal diverticulitis and 398 (86.9%) to have acute appendicitis. Patients with appendiceal diverticulitis were older (59 vs 37 years, P < 0.001) and had a longer duration of the illness (4.0 d vs 1.0 d, P < 0.001). Perforation rates in patients with appendiceal diverticulitis were higher (68% vs 27%, P < 0.001). The appendix could be visualized in only 13 patients (52%) among the appendiceal diverticulitis cases, but in all acute appendicitis cases. CT findings suggestive of appendiceal diverticulitis included the absence of fluid collection in the appendix (84% vs 12%, P < 0.001), absence of appendicolith (92% vs 52%, P = 0.005), and formation of abscess (68% vs 16%, P < 0.001). Appendiceal diverticula were identified in 6 patients (24%).
CONCLUSION: Among patients who had undergone appendectomy, 9.7% had appendiceal diverticulitis. Patients with appendiceal diverticulitis had different clinical features and CT findings from patients with acute appendicitis.
Core tip: To study the clinical features and computed tomography (CT) findings of appendiceal diverticulitis, we retrospectively reviewed 451 patients who had undergone appendectomy in our institution. Among 451 patients, 44 (9.7%) were diagnosed with appendiceal diverticulitis. Patients with appendiceal diverticulitis were older and had a longer duration of illness. Perforation rates in patients with appendiceal diverticulitis were higher. CT findings suggestive of appendiceal diverticulitis included the absence of a fluid collection in the appendix, absence of an appendicolith (92% vs 52%, P = 0.004), and abscess formation. These findings make it possible to clinically differentiate appendiceal diverticulitis from acute appendicitis.