Appendiceal diverticulitis: diagnosis and differentiation from usual acute appendicitis using computed tomography.
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.
Lee
Kyoung Ho
KH
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
Lee
Hye Seung
HS
Park
Seong Ho
SH
Bajpai
Vasundhara
V
Choi
Yoo Shin
YS
Kang
Sung-Bum
SB
Kim
Kil Joong
KJ
Kim
Young Hoon
YH
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D004238:Diverticulitis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide