Presentation
Abdominal pain. Appendicitis or diverticulitis?
Patient Data
A small focus of inflammatory change is demonstrated in the right iliac fossa, with a central tubular structure that appears to arise from the ileum. On the previous CT, a blind ending tubular structure is shown arising from a similar part of the ileum. The appendix, cecum and ascending colon are normal. The remainder of the small bowel is unremarkable. No peritoneal free fluid or free gas. No enlarged abdominal or pelvic lymph nodes. Colonic diverticulosis is noted, with no pericolic inflammatory change demonstrated. A small segment of thickening in the distal sigmoid colon is noted in relation to diverticula. The liver, spleen, pancreas, adrenals, kidneys (apart from simple cyst) and stomach are normal. The lung bases are clear. Old rib fractures noted. No suspicious bony lesions.
Conclusion:
Inflammatory change centered around a tubular structure arising from the ileum consistent with perforated Meckel's diverticulitis. Short segment of sigmoid colon thickening likely related to diverticular disease.
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