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A Rare Case of Acute Urinary Bladder Diverticulitis Mimicking Acute Appendicitis

Min-On Tan, Wai Loon Yam, Yung Khan Tan, Sing Joo Chia, Keng Sin Ng

(Department of Radiology, Changi General Hospital, Singapore, Singapore)

Am J Case Rep 2020; 21:e925236

DOI: 10.12659/AJCR.925236

BACKGROUND: Urinary bladder diverticula are common. They are typically asymptomatic and usually discovered incidentally. Urinary bladder diverticulitis, in contrast to colonic diverticulitis, is an extremely rare occurrence.
CASE REPORT: We describe a case of a 52-year-old man who presented with isolated urinary bladder diverticulitis mimicking acute appendicitis. Focal inflammation of a urinary bladder diverticulum along the right lateral urinary bladder wall caused right iliac fossa pain. Predominant findings of red blood cells in the urine were not dissimilar to per rectal bleeding seen with colonic diverticulitis. Cystoscopy and uroflow dynamic study revealed features of chronic urinary bladder outlet obstruction despite a computed tomography scan showing a minimally enlarged prostate gland and the patient reporting no lower urinary tract symptoms.
CONCLUSIONS: Urinary bladder diverticulitis is a very rare condition with poorly understood underlying etiology. Hematuria is possibly an important presentation correlating with the per rectal bleeding seen with colonic diverticulitis. Depending on its position relative to the urinary bladder wall, it can mimic other more common presentations. Follow-up investigations using cystoscopy and uroflow studies are useful to evaluate for findings associated with chronic urinary bladder outlet obstruction.

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