Cecal Diverticulitis: an uncommon differential diagnosis from appendicitis

Abstract

Therefore, we will report the unusual case of a patient, who was submitted to surgery for suspected appendicitis and during the intraoperative period it was observed that he had diverticulitis of cecum. Case reportPatient, 42 years old, male, reported a lancinating pain in the lower right quadrant of the abdomen for 48 hours, associated with episodes of unmeasured fever and chills, denying vomiting, adynamia and changes in bowel habit. Physical examination revealed the presence of localized tenderness and painful decompression in right lower quadrant of abdomen, described as a Blumberg signal.A hemogram showed 9,800 leukocytes per mm 3 . The patient had undergone a surgical procedure. It was initially performed as a Davis incision, which revealed hyperemia of the vermiform appendix and inflammatory mass surrounding a perforated cecum. So, the surgical team changed to xipho-pubic incision in order to perform a ileotiflectomy. The bowel transit was reconstructed by side-to-side ileotransverse anastomosis. The patient recovered well in the postoperative staying and was discharged after 6 days. Histopathological examination revealed: diverticular disease of the colon with diverticulitis and perforation associated with lymphoid hyperplasia of the cecal appendix.