Daniel W Kauff1, Roman Kloeckner2, Sohall Frogh3, Hauke Lang4. 1. Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckst. 1, 55131, Mainz, Germany. daniel.kauff@unimedizin-mainz.de. 2. Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany. 3. Department of Medicine I, University Medical Center of Johannes Gutenberg-University, Mainz, Germany. 4. Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckst. 1, 55131, Mainz, Germany.
Abstract
PURPOSE: Cecal diverticulitis is a rare entity causing right iliac fossa pain. Its symptoms may mimic acute appendicitis. Therefore, the majority of these patients undergo unnecessary surgery for suspected diagnosis of appendicitis. METHODS: We report a case series of solitary cecal diverticulitis, right-sided colonic diverticulitis, and perforated cecal diverticulitis diagnosed by computed tomography scan. RESULTS: The first two cases were successfully managed conservatively with intravenous antibiotics, rehydration, and temporary bowel rest. The third case developed a retroperitoneal abscess, which was initially drained under computed tomography guidance. However, due to development of septicemia, the patient underwent urgent right hemicolectomy. All patients recovered and were discharged during the further course. CONCLUSIONS: Computed tomography is of great value for the diagnosis of cecal diverticulitis and its differentiation from acute appendicitis. Conservative treatment is sufficient in uncomplicated cases, while surgery is reserved for those with associated large abscess or free perforation.
PURPOSE: Cecal diverticulitis is a rare entity causing right iliac fossa pain. Its symptoms may mimic acute appendicitis. Therefore, the majority of these patients undergo unnecessary surgery for suspected diagnosis of appendicitis. METHODS: We report a case series of solitary cecal diverticulitis, right-sided colonic diverticulitis, and perforated cecal diverticulitis diagnosed by computed tomography scan. RESULTS: The first two cases were successfully managed conservatively with intravenous antibiotics, rehydration, and temporary bowel rest. The third case developed a retroperitoneal abscess, which was initially drained under computed tomography guidance. However, due to development of septicemia, the patient underwent urgent right hemicolectomy. All patients recovered and were discharged during the further course. CONCLUSIONS: Computed tomography is of great value for the diagnosis of cecal diverticulitis and its differentiation from acute appendicitis. Conservative treatment is sufficient in uncomplicated cases, while surgery is reserved for those with associated large abscess or free perforation.