Acquired Diverticulosis of the Vermiform Appendix: A Disease of Multiple Etiologies

Acquired diverticular disease of the vermiform appendix is a rare condition that usually presents with the symptoms of acute appendicitis. This analysis was undertaken to determine the spectrum and prevalence of the associated lesions in acquired appendiceal diverticulosis. Thirty-one cases of acquired appendiceal diverticular disease were identified from files over a period of 15 years (1982-1996). Diverticulosis was the only abnormality in 17 cases (54.8%). An associated neoplastic epithelium was present in nine (29%) patients (seven adenomata and two goblet cell carcinoids), fecalith formation in three (9.7%), and a neuroma in two (6.5%). Although rare, diverticular disease of the vermiform appendix was frequently seen in association with an adenomatous mucosa. In our experience, one appendiceal adenoma coexisted with a colonic adenocarcinoma. In conclusion, the diagnosis of appendiceal diverticulosis necessitates the exclusion of coexisting appendiceal neoplasia.