Acute Diverticulitis: A Rare Cause of Abdominal Pain

Abstract

There is an increasing incidence of diverticulosis and diverticulitis in the younger populations; and its occurrence in very young individual is concerning. Here we report a rare and interesting case of a 20-year-old man who presented with 3-day history of epigastric abdominal pain associated with diarrhea and nausea. His abdominal examination revealed mild tenderness in the right lower abdominal quadrant. Computed tomography (CT) scan of abdomen with intravenous contrast revealed scattered diverticula throughout the colon with focal thickening, pericolonic infiltrative changes suggestive of acute diverticulitis in the distal ascending colon. He was treated with intravenous hydration and antibiotics and discharged when his clinical status improved. He underwent colonoscopy 1 month later which showed pan diverticulosis. This case illustrates the importance of considering acute diverticulitis in the differential diagnosis of right lower quadrant pain when evaluating a young patient.

Right-Sided Diverticulitis: A Rare Cause of Right-Sided Abdominal Pain

“…Conservative therapy is indicated for uncomplicated acute diverticulitis. The use of antibiotic medication for the treatment of uncomplicated acute diverticulitis is crucial [1]. The issue…”

Congenital cecal diverticulitis in a pediatric patient

“…Presenting with inflammation or infection of the diverticulum is even more rare, considering that less than 5% of all patients with diverticula of any etiology develop diverticulitis [ 1 ]. Although approximately 65% of the Western population has diverticulosis by 85 years old, the prevalence in the population younger than 40 is only 10% [ 2 ]. The highest increase in incidence of diverticulitis within recent decades falls within this age group.…”

“…Overall, right sided diverticular disease should be considered distinct from left sided and is more likely to have a genetic predisposition [ 4 ]. These include connective tissue diseases such as Marfan syndrome or Ehlers-Danlos, Williams-Beuren syndrome, or neural abnormalities such as hypo-ganglionosis or aganglionosis of the intestine [ 2 ].…”

“…In regard to laboratory results, some studies have stated that there may be a mildly elevated WBC count with a higher percentage of lymphocytes in acute diverticulitis as compared to what is expected in appendicitis [ 8 ]. CT of the abdomen and pelvis with oral and IV contrast is the current test of choice for diagnosing acute diverticulitis, as well as differentiating other conditions that may mimic acute appendicitis [ 2 ]. If further imaging is needed to confirm the diagnosis, MRE can be performed.…”

Diagnóstico, evaluación y tratamiento de la apendicitis aguda en el servicio de emergencias

“…Se le realiza un TAC que documenta la presencia de divertículos a lo largo del colon y una diverticulitis en colon ascendente y el apéndice. El estudio concluye que la diverticulitis derecha tiene una presentación clínica muy similar a la apendicitis aguda y por esta razón siempre se debe considerar como diagnóstico diferencial de dolor abdominal en cuadrante inferior derecho, principalmente en la población asiática (10). Enfermedad de Crohn.…”