Background. Diverticular disease of the appendix (DDA) is a rare disease and it has been shown to be associated with locoregional neoplasms. This study was conducted to characterize clinicopathological features and to investigate its association with appendiceal neoplasms. Methods. We searched the records of the Department of Pathology at Farwaniya Hospital for cases of diverticular disease of the appendix between 2003 and 2011. Histological slides and patient charts were reviewed for relevant information. Consecutive cases of acute appendicitis were selected as a control group. Results. We identified 25 cases of DDA, 24 of which occurred in men. Mean age of DDA patients was 35 ± 10.1 years and was significantly greater than that of appendicitis patients ( ). The mean temperature of cases (37.9°) was significantly higher ( ) than that of the controls (37.3°). The cases had lower white blood cell (WBC) counts compared to controls (13.6 versus 16.7, ). Pathological diagnosis identified 4 cases of diverticulosis, 5 cases of diverticulitis, 6 cases of diverticulosis with acute appendicitis, and 10 cases of diverticulitis and appendicitis. None of the cases was associated with any type of neoplasm. Conclusions. DDA is a rare disease, and clinicians and radiologists should be aware of it. Male sex and adult age seem to be risk factors associated with DDA. The disease may not have any direct association with any neoplasm. 1. Introduction Diverticular disease of the appendix (DDA) is a rare disease characterized by herniation or outpouching of the appendiceal mucosa through the muscular wall. Congenital DDA is rare, with a reported prevalence of 0.014%. It is equally frequent in both sexes and commonly presents as a single diverticulum [1]. Acquired DDA is also rare; it has been reported in 0.2% to 1.7% of all appendectomy specimens [2, 3]. In the medical literature, there are only few studies on DDA because the disease is extremely rare. Moreover, it is commonly overlooked by clinicians, radiologists, and surgeons because its clinical characterizations are limited, as is awareness of its complications. In relatively recent years, researchers have noticed an association between DDA and appendiceal neoplasms. Lamps et al. [4] reported a 25% association between appendiceal mucinous neoplasms and DDA. A study by Dupre et al. [5] revealed that 48% of appendectomy specimens with diverticulosis harbored appendiceal neoplasms including well-differentiated neuroendocrine tumors (carcinoid), mucinous adenoma, tubular adenoma, and adenocarcinoma. Furthermore, a recent
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