Appendiceal diverticulitis: diagnosis and differentiation from usual acute appendicitis using computed tomography

Abstract

Objective: To describe the computed tomographic findings of appendiceal diverticulitis.

Methods: Computed tomography (n = 20) and clinical findings in 23 patients with appendiceal diverticulitis were retrospectively reviewed and compared with those in 23 patients with usual acute appendicitis.

Results: Computed tomography visualized the inflamed diverticula (up to 4 per patient) mostly as small (median, 7.5 mm) round cystic outpouchings at the distal appendix with contrast enhancement at the cyst wall in 16 (80%) patients with appendiceal diverticulitis. In 50% of appendiceal diverticulitis patients, computed tomographic diagnosis of accompanying appendicitis was false positive. Appendicolith was rarely observed in the appendiceal diverticulitis group (5% vs 48%, P = 0.002). No significant difference was observed in the clinical findings except for the patient age (median, 45 vs 31 years; P = 0.001).

Conclusions: Most appendiceal diverticulitis can be differentiated from usual acute appendicitis at computed tomography by visualization of the inflamed diverticulum.