Appendiceal diverticulitis shortly after a performed laparoscopic sigma resection

Diverticulosis of the vermiform appendix is rare and usually asymptomatic or associated with mild, chronic or intermittent abdominal pain. A 52-year-old patient was admitted to our department due to lower abdominal pain. Assuming the second episode of diverticulitis of the sigmoid, a computed tomography (CT) was performed, and complicated sigmoid diverticulitis and an accentuated appendix without inflammatory signs were diagnosed. Laparoscopic sigmoid resection was performed with an intraoperative macroscopic inconspicuous appendix. Two months later, right-sided abdominal pain returned. CT scan showed increasing signs of thickened appendix. Because of a gallbladder polyp, a combined laparoscopic appendectomy and cholecystectomy with one additional laparoscopic access was performed. Pathology detected a small diverticulum of the appendix and a small tubular adenoma with low-grade intraepithelial neoplasia in the gallbladder. Although diverticulitis of the appendix is very rare, it should be considered in patients with right lower abdominal pain, and appendectomy should be performed even in macroscopic unsuspicious cases.