Acute phlegmonous appendicitis in rare variant of appendix diverticulum (case report)

Abstract

Background. Appendicitis-like diverticulitis is considered a rare disease and is usually the subject of clinical reports. Clinical manifestations of this pathology is similar to those of appendicitis, which is why a preoperative diagnosis is made quite rarely. When carrying out the study, we considered a clinical case of acute phlegmonous appendicitis with a rare variant of the appendix wall diverticulum.Material and methods. To assess clinical cases, a retrospective analysis of medical documentation (medical records of patients with diverticulitis in particular) was used. The assessment of clinical symptoms was accompanied by using general clinical, histological and microbiological methods.Results. Patient I., 62 years old, was diagnosed with acute appendicitis. An urgent appendectomy was carried out, during which the vermiform process was removed. It was located retrocecally, in the adhesive process and loose infiltrate. The length of the process is 7–8 cm, its diameter is 1–1,5 cm. 6 diverticula up to 0,7 cm in size are visible. When the process is cut, the pyoid contents protrudes from its lumen. In addition, the appendix removed during appendectomy was sent for pathological study. A standard histopathological study was carried out with the step-like sectioning and hematoxylin and eosin staining.Conclusion. From the results of a pathological study, it was found that the layers of the vermiform process wall with diverticula are diffusely infiltrated by polymorphonuclear leukocytes. The mucous membrane is anesthetized and had ulcerative defects. The patient was diagnosed with phlegmonous appendicitis, periappendicitis, diverticulitis.Vermiform process diverticulitis is not a common pathology, however a timely diagnosis can cause quite severe complications.