True Diverticulosis of the Appendix

Ryo Takahashi, Takeshi Kaneko, Noboru Nakayama, Yoshiki Kataoka, Masanobu Washida, Seiji Yamasaki and Tatehiro Kajiwara

Department of Surgery, Hamamatsu Rosai Hospital

A 82-year-old woman seen for lower abdominal pain was found in computed tomography to have a grape-like cystic mass with increased fat density below the ileocecal region. We conducted appendectomy under a diagnosis of acute appendicitis or appendiceal tumor. Resected specimen showed diverticulosis. Pathological examination indicated acute inflammation only at the tip of the appendix, and chronic inflammation at the true diverticulosis. True diverticulosis is rare, with only 6 cases reported in the Japanese literature. Some investigators recommend prophylactic appendectomy for asymptomatic appendiceal diverticulosis because it is highly prone to perforate in the presence of acute inflammation. This opinion has been based on inaccurate citation from outdated literature, acute appendicitis has equivalent risk of perforation among aged patients 65 years and older. We hold that no reason exists for prophylactic appendectomy in asymptomatic appendiceal diverticulosis.

Key words
appendiceal diverticulosis, true diverticulum, prophylactic appendectomy

Reprint requests
Ryo Takahashi Department of Surgery, Hamamatsu Rosai Hospital
25 Syougen-cho, Higashi-ku, Hamamatsu, 430-0802 JAPAN

Accepted
October 29, 2007

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