PMC5206413_01
Computed tomography revealed diverticula sequentially located in the wall thickening terminal ileum (arrows); surrounding abdominal fat was developing high density suggesting inflammation. The appendix was not swollen (arrow head).
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C-reactive protein level of 2.6 mg/L, and white blood cell count was 20,700/muL. Computed tomography (CT) revealed sequential diverticula in the wall thickening terminal ileum with high density of surrounding fat (arrows in Figures 1(a) and 1(b)) and appendix without swelling (Figure 1(b) arrow head) and also multiple uncomplicated diverticula in the ascending colon separated from the panniculitis lesion were detected.
Computed tomography revealed diverticula in the terminal ileum (arrow) and swollen appendix with 10 mm in the diameter (arrow head).
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Abdominal enhanced CT performed at previous hospital which showed diverticula in the terminal ileum with high density of surrounding fat (Figure 2(a) arrows) and appendix with 10 mm swelling (Figure 2(b) arrow head).
Surgically resected specimen revealed diverticula on the mesenteric side in the terminal ileum ((a) and (b)). Microscopically, the nodular areas correspond to points of mucosal invagination into the surrounding muscular layer, creating diverticula (c). There is inflammatory granuloma that consisted of foreign body giant cells (arrows in (d)) and foam cells (arrow heads in (d)) in the invaginated area.
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The resected specimen revealed diverticulitis in the terminal ileum on the mesentery side (Figures 3(a) and 3(b), arrows). On microscopic evaluation, the nodular areas correspond to points of mucosal invagination into the surrounding muscular layer, creating diverticula (Figure 3(c)). There was inflammatory granuloma that consisted of foreign body giant cells (Figure 3(d) arrows) and foam cells (Figure 3(d) arrow heads) in the invagination area.