Concurrent Acute Appendicitis and Recurrent Acute Diverticulitis: A Diagnostic Challenge
Ahmad S. Hussain, MD, Oliver L. Gunter, MD, Richard S. Miller, MD, Hugo J. R. Bonatti, MD
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA (all authors).
Introduction: There is a lack of information in the literature regarding acute appendicitis in the setting of acute diverticulitis. As acute appendicitis and acute diverticulitis together make up most community-acquired complicated intra-abdominal infections, it is very likely that the provider will encounter them in the patient presenting with abdominal pain.
Case Description: We report a patient with recurrent diverticulitis who carried a codiagnosis of acute appendicitis; the appendix was laparoscopically removed, and her diverticulitis flare was managed nonoperatively.
Discussion: In the patient with a history of diverticulitis presenting with abdominal pain, a high index of suspicion for other coexisting intra-abdominal pathology must be maintained. Computed tomography offers a powerful tool to aid in diagnosis.
Key Words: Appendicitis, Diverticulitis, Laparoscopy, Surgery.