Early appendicitis--a safe diagnosis?

Serosal inflammation of the appendix in association with a significant peritoneal exudate can be mistaken for early acute appendicitis. We highlight the importance of looking for other sources of intra-abdominal sepsis in this clinical setting. We present 3 cases of so-called "mild" appendicitis with serosal inflammation that was ultimately shown to be caused by Meckel's diverticulitis. All 3 patients initially underwent an appendicectomy. In 2 of these cases, a further laparotomy and excision of a Meckel's diverticulum was carried out. All 3 made an uneventful recovery. Meckel's diverticulitis can mimic acute appendicitis in clinical history, physical findings and operative findings. It is important to always consider this as a possible cause for an acute abdomen.