Acute gastrointestinal bleeding from appendiceal diverticulitis diagnosed preoperatively by combined short-interval computed tomography and colonoscopy: A case report

Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding^1,2. Appendiceal diverticulosis is an uncommon clinical entity, with an incidence of 0.004%-2% in surgical pathologic specimens^3,4. Appendiceal diverticulitis in symptomatic patients should be treated with early resection, because of the risk of perforation and peritonitis; the rate of perforation is higher in appendicitis (27%) with diverticulosis than in appendicitis alone (6.6%)⁵. Untreated appendiceal diverticulitis can also lead to massive gastrointestinal hemorrhage and abscess formation, and has a potential role in the development of pseudomyxoma peritonei. Preoperative diagnosis is difficult, and final diagnosis is often determined by histopathological examination after appendectomy. Moreover, preoperative imaging has rarely been reported.

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