虫垂真性憩室炎の１例

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  • A CASE OF TRUE DIVERTICULITIS OF THE APPENDIX

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A 43-year-old man was seen at the hospital because of right lower abdominal pain. Abdominal CT scan showed mild swelling of the appendix and air in the vicinity of the appendix. With the most likely diagnosis of penetration of acute appendicitis into appendiceal mesentery or diverticulitis of the appendix, surgery was performed on the same day. During surgery, purulent ascites around the appendix and the slightly swollen appendix were noted. And redness and hypertrophy of the appendiceal mesentery were seen. Appendectomy was carried out. On the resected material, fecalith was identified near the root of appendix, and deverticulum was present on the mesentery side of the appendix. Histopathologically the appendiceal diverticulum was true diverticulum in which the proper muscular layer was kept intact. Perforation was identified in a part of the diverticulum, with abscess formation around it, so that diverticulitis of the appendix was definitely diagnosed.<br>Diverticulosis of the appendix is a relatively uncommon entity. Clinically it can perforate in a high frequency, and it poses the problem of indicating surgery if the disease is detected in asymptomatic subjects. If perforation once occurs to develop inflammation, serious complications are often associated. Strict care must be exercised for asymptomatic patients as well as those who are suspected to have inflammation.

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