When diverticulitis of the appendix mimics appendicitis: a case report

Appendiceal diverticulosis is a rare and often incidental finding, with significant clinical relevance due to its association with increased risk of perforation and malignancy. It is frequently misdiagnosed as conventional appendicitis due to overlapping clinical presentations. A patient presented to the Emergency Department with a 3-day history of progressively worsening abdominal pain, localized to the right iliac fossa. The patient had a recent history of hospitalization for acute appendicitis with formation of an appendiceal mass (plastron), which was managed conservatively with antibiotic therapy. Elective surgical intervention was planned following resolution of the acute phase. The patient subsequently underwent a laparoscopic appendectomy without intraoperative complications. Histopathological examination of the surgical specimen revealed a vermiform appendix with multiple diverticula, without evidence of acute inflammation. Subserosal haemorrhage was noted. No signs of neoplasia were identified. The patient had an uneventful postoperative recovery and was discharged on postoperative day one. This case highlights the importance of considering appendiceal diverticulosis in the differential diagnosis of acute appendicitis. Awareness of this entity can aid in better risk stratification and postoperative management.