INCIDENTALLY DIAGNOSED APPENDIX DIVERTICULOSIS AFTER APPENDECTOMY

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Title:
 Incıdentally Diagnosed Appendix Diverticulosis After Appendectomy
 Short Title:
 Appendix Diverticulosis
 Abstract 
 Appenix diverticulitis was first described by Kelynack in 1893. Appendix diverticulosis is a rare clinical manifestation of the appendix with a changing rate of 0.004 to 2.1% of all appendectomies. Generally diagnosed in males, and the mean age is 38. Appendix diverticulosis may be inflamed and result in appendix diverticulitis or can be incidentally diagnosed by acute appendicitis. Clinical presentation of appendix diverticulitis may be similar to acute appendicitis but clinical signs may occur slowly and mildly. 
 The thirty-five-year-old male patient was admitted to the emergency department with right lower quadrant pain. The patient has abdominal tenderness, rebound, and defense reactions with other intraabdominal infections signs. Abdominal ultrasonography was performed and appendix diameter was measured enlarged, and inflammation signs were observed in the surrounding tissue in favor of acute appendicitis. A laparoscopic appendectomy was performed. During the operation, three small herniated tissue was observed on the anti-mesenteric surface of the appendix. Acute phlegmonous appendicitis and appendix diverticulosis diagnosis were confirmed with the histopathological examination.
 Appendix diverticulosis may occur either acquired or congenital. The congenital diverticulosis is generally located on the anti-mesenteric edge and contains all layers of the appendix wall. Diagnosed appendix diverticulosis is acquired type predominantly. Appendix diverticulosis is diagnosed more commonly in patient who has cystic fibrosis or Hrschsprung’s disease. However, no relationship between colon diverticular disease and appendix diverticula has been found. There is a high risk of appendiceal neoplasms such as carcinoid tumors and mucinous adenomas. The gold standard to diagnose appendix diverticula is histopathological examination.