Acute Diverticulitis of the Cecum and Ascending Colon

Jang, Hyun‐Jung; Lim, Hyo Keun; Lee, Soon Jin; Lee, Won Jae; Kim, Eung Yeop; Kim, Seung Hoon

doi:10.2214/ajr.174.5.1741397

Cited by 91 publications

(16 citation statements)

References 24 publications

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“…MRI of right-side diverticulitis may reveal an out pouching of the right colon with associated circumferential wall thickening of the colon and surrounding inflammatory changes [19] Some authors suggested ultrasound and CT scan as routine use for abdominal pain of the right lower quadrant, which would probably reduce surgeries and hospital stays [4]. Recognition of specific imaging findings enables the radiologist to make the correct diagnosis and helps in establishing the appropriate surgical or medical therapy, thus avoiding unnecessary exploration or surgery for some of these surgical conditions, which mimicked acute appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Diverticular disease of the right colon

2011

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BackgroundThe incidence of colonic diverticular disease varies with national origin, cultural background and diet. The frequency of this disease increases with advancing age. Right-sided diverticular disease is uncommon and reported to occur in 1-2% of surgical specimens in European and American series. In contrast the disease is more prevalent and reported in 43-50% of specimens in Asian series. Various lines of evidence suggest this variation may represent hereditary differences. The aim of the study is to report all cases of right sided diverticular disease underwent surgical resection or identified during pathological examination of right hemicoloectomy specimensMethodsA retrospective review of all surgical specimens with right sided colonic diverticular disease selected from a larger database of all colonic diverticulosis and diverticulitis surgical specimen reported between January 1993 and December 2010 at the Pathology Department McMaster University Medical Centre Canada. The clinical and pathological features of these cases were reviewedResultsThe review identified 15 cases of right colon diverticulosis. The clinical diagnoses of these cases were appendicitis, diverticulitis or adenocarcinoma. Eight cases of single congenital perforated diverticuli were identified and seven cases were incidental multiple acquired diverticuli found in specimen resected for right side colonic carcinomas/large adenomas. Laparotomy or laparoscopic assisted haemicolectomies were done for all cases. Pathological examination showed caecal wall thickening with inflammation associated with perforated diverticuli. Histology confirmed true solitary diverticuli that exhibited in two cases thick walled vessels in the submucosa and muscular layer indicating vascular malformation/angiodysplasia. Acquired diverticuli tend to be multiple and are mostly seen in specimens resected for neoplastic right colon diseases.ConclusionSingle true diverticular disease of the right colon is usually of congenital type and affects younger age group and may be associated with angiodysplasia in some cases. Multiple false diverticuli are more seen in association with caecal carcinoma or large adenomas. These are usually asymptomatic and are more seen in older patients. However this study dose not reflects the true incidence of the disease in the general population.

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Section: Discussionmentioning

confidence: 99%

Diverticular disease of the right colon

2011

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“…Findings on CT scan consistent with a diagnosis of right colon diverticulitis are similar to those appreciated with left-sided disease. Findings include colonic wall thickening, presence of extraluminal mass, haziness and stranding of adjacent pericolic fat, and thickening of nearby fascial planes [9–12]. Though CT scan has a documented diagnostic accuracy rate of 90% to 95%, right-sided diverticulitis may still be radiographically mistaken for appendicitis with abscess, Crohn's disease, omental infarction, or colon cancer [9–11].…”

Section: Literature Reviewmentioning

confidence: 99%

“…On US, the presence of rounded hypo- or anechoic structures that protrude from thickened bowel wall, with or without strong echoes representing gas, feces or stone, is consistent with a diagnosis of right-colonic diverticulitis [13]. US for right-sided diverticulitis, when performed by an experienced operator, has quoted 91.3% sensitivity and 99.8% specificity for correct diagnosis [9, 12–14]. …”

Section: Literature Reviewmentioning

confidence: 99%

Current Recommendations on Diagnosis and Management of Right-Sided Diverticulitis

Telem

Buch

Nguyen

et al. 2009

Gastroenterology Research and Practice

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“…Jang et al stated in their study that differentiation between diverticulitis and carcinoma could be made with thin slice CT with 92.5% accuracy rate [9]. And in another study they stated that CT was 85% precise, 68% selective, 28% positive predictive, 97% negative predictive, and 70% diagnostically accurate for right colon diverticulitis [8].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Right Lower Quadrant Pain: The Caecum Diverticulitis

Yildar

Özkan²,

Çağlayan

et al. 2012

Case Reports in Surgery

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Purpose. In the study presented, preoperative examinations and surgical methods were discussed along with literature, regarding two cases who were operated with the prediagnosis of acute appendicitis and for whom caecum diverticulitis was determined. Case 1. 21 years old male patient who had applied to hospital with complaint of abdominal pain, underwent an operation with a prediagnosis of acute appendicitis. Right hemicolectomy was performed with mass perioperatively determined in caecum. Histopathological examination revealed necrosis and inflammation in diverticulum wall. Case 2. 36 years old female patient applied to emergency department with abdominal pain and underwent an operation with a prediagnosis of acute appendicitis. Appendectomy and diverticulectomy were performed for whom inflame diverticula in caecum was determined perioperatively. Histopathological examination was revealed acute inflammation in diverticulum wall. Conclusion. Although solitary caecum diverticulitis is a rarely encountered disease, it must be considered in the differential diagnosis of right lower abdomen pain.

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Acute Diverticulitis of the Cecum and Ascending Colon

Cited by 91 publications

References 24 publications

Diverticular disease of the right colon

Diverticular disease of the right colon

Current Recommendations on Diagnosis and Management of Right-Sided Diverticulitis

An Unusual Cause of Right Lower Quadrant Pain: The Caecum Diverticulitis

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