A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst

Abstract

We report a case of a 32-year-old woman with episodic right lower quadrant abdominal pain. With the diagnosis of either acute appendicitis or tubo-ovarian abscess, she was treated with antibiotics, which successfully relieved the pain and the inflammatory findings. She repeated the clinical condition a few times and antibiotics worked each time. In a year, her subjective symptoms became milder, however, a giant pelvic cyst appeared. She had an exploratory laparotomy to confirm this diagnosis. Histopathological studies revealed herniated appendiceal mucosa through the muscular layer associated with chronic inflammation and marked fibrosis. Gynecological disorders such as endometriosis or lutein cyst rupture was denied. These findings represent appendiceal diverticulitis. We discuss the clinical features of the disease and its relation with the pelvic pseudocyst.

Figure 1

Pelvic CT shows a whip-shaped low density structure with a high density spot along the bulging right pelvic wall.

Figure 2

Pelvic CT in 4 mo. A cyst in cyst structure and the high density spot in the right iliac fossa were revealed.