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

J Comput Assist Tomogr. 2007 Sep-Oct;31(5):763-9. doi: 10.1097/RCT.0b013e3180340991.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Appendicitis / diagnostic imaging*
  • Appendix / diagnostic imaging*
  • Appendix / pathology
  • Child
  • Contrast Media
  • Diagnosis, Differential
  • Diverticulitis / diagnostic imaging*
  • Female
  • Humans
  • Iohexol / analogs & derivatives
  • Male
  • Middle Aged
  • Random Allocation
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iohexol
  • iopromide