case_images: PMC11032055_01
case_images: (A) Gray-scale ultrasound image showed an inflamed appendiceal diverticulum containing feces (asterisk), with surrounding fatty infiltration (curved arrow). (B) Oblique sagittal plane CT image shows an enlarged appendix (dashed line) with several fecal-containing diverticula (asterisk) and surrounding fatty infiltration (curved arrow). Note that the root (red arrowheads), and the body and tip of the appendix (straight arrows) were normal size. (C) Image taken during laparoscopic appendectomy showed an enlarged appendix with a red inflamed diverticular surface (asterisk). (D-F) Surgical specimen showed normal appendicular root (red arrowheads) and body (yellow open arrows), appendiceal diverticulitis (asterisks), congested superficial blood vessels (black solid arrows), and appendiceal diverticulum hole (circle).
case_images: 10.1177_2632010X241248909-fig1.jpg
case_images: PMC11032055_01_10.1177_2632010X241248909-fig1.jpg
case_images: fig1-2632010X241248909
case_images: Ultrasound images showed infiltrations in the right iliac fossa, suspicious for intestinal diverticulitis (Figure 1A). Computed tomography (CT) was performed for further evaluation and showed an appendix with a transverse diameter of about 6 to 9 mm, a lumen containing feces with fluid and air, and a thin wall (Figure 1B). During surgery, the appendix was found to be large, irregularly hyperemic surface, with several protruding diverticular-like areas, and among them was an inflamed diverticulum (Figure 1C). The dissected appendix specimen showed multiple feces and 3 diverticula, one of which was inflamed (Figure 1D and F).
case_images: Microscopic images of the appendix specimen with diverticula (hematoxylin-eosin stain). (A) There was infiltration of acute inflammatory cells into the diverticular mucosa (arrows). (B) Appendiceal mucosa was infiltrated with plasma cells (blue circle), polymorphonuclear leukocytes (green circles), and eosinophils (yellow circle). (C) Diverticulum mucosa was infiltrated with plasma cells (blue circle), eosinophils (yellow circle), neovascularization (green arrows), and fibrous hyperplasia (red double-headed arrow). (D) Appendiceal diverticula had thin muscle layer (yellow double-headed arrow).
case_images: 10.1177_2632010X241248909-fig2.jpg
case_images: PMC11032055_01_10.1177_2632010X241248909-fig2.jpg
case_images: fig2-2632010X241248909
case_images: Histopathology confirmed acute appendiceal diverticulitis and congestive appendicitis (Figure 2).