Diverticulitis of the appendix: is it clinically significant?

We represent here, a case of male patient aged 32 years coming complaining of diffuse periumbilical pain since 2 days that shifted to the right iliac fossa and suprapubic areas within 6 h from onset. The condition was accompanied by vomiting (once), constipation, and fever. Abdominal examination revealed tender Mc-Burney point with rebound tenderness in the right iliac fossa; he had a pulse of 97 beats/min, temperature of 38.1΀C, and total leukocytic count of 9000 c/m. Ultrasonography revealed minimal free fluid with noncompressible tubular blind structures, indicating acute appendicitis Figure 1. The patient was prepared for appendectomy in the usual manner through Lan's incision. On operation, two bulges were found arising from the antimesenteric border of the distal half of the appendix Figure 2 as diverticulae with impending rupture of one of them Figure 3. Both the appendix and diverticulae are seats of inflammation Figure 4. Appendectomy was performed and the specimen was sent for histopathologic examination, revealing diverticulitis of an inflamed appendix (type 2 diverticulosis of the appendix). We reviewed the literature to study cases on such a clinical entity and determine whether appendectomy was sufficient in all cases and whether there was actual increased risk for another diverticulae elsewhere.