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Appendicitis with diverticulitis

Case contributed by Mohamed Adel Sherif
Diagnosis certain

Presentation

Right iliac fossa pain and tenderness.

Patient Data

Age: 30 years
Gender: Male
ultrasound

Dilated non-compressible aperistaltic retrocecal appendix, 15 mm in diameter, with multiple (about three) wall diverticular outpouchings showing muscular layer defects.

Minimal localized fluid collection.

No mass formation.  

Long dilated (measuring 15.8 mm) retrocecal appendix with multiple wall irregularities and diverticula, with minimal surrounding fat stranding.

Normal cecum and right colon. No diverticulosis.

Case Discussion

The patient presented with deep right iliac fossa pain and tenderness. Imaging (US and CT) was suggestive of appendicitis with appendiceal diverticulosis.

Histopathology after appendectomy: Low-grade neuroendocrine tumor (T1NxMx) measures 5 mm at the base of the appendix. The residual appendix shows appendicitis and diverticulitis.

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