Solitary caecal diverticulitis; comparison of operative and non-operative treatment

Kaya, Cemal; Celayir, Mustafa Fevzi; Bozkurt, Emre; Ömeroğlu, Sinan; Güven, Onur; Mihmanlı, Mehmet

doi:10.5455/jpma.12674

Cited by 3 publications

(8 citation statements)

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“…Patients affected by ARCD typically presented at the emergency department with fever, pain in the right iliac fossa and often signs of peritoneal irritation. Blood tests show leukocytosis and increased C-reactive protein[ 12 - 15 , 18 , 19 , 24 - 27 ]. Similar symptoms and young age are confounding factors and they can be wrongly identified with the diagnosis of acute appendicitis in most of the cases described[ 14 , 15 , 17 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…The importance of tomography is clear in the article by Cristaudo et al [ 21 ] in which CT scan was necessary to detect the pathology in 90% of cases. Also, in the study of Kaya et al [ 27 ] in which CT scan recognized aggressive liver cancer domains (ALCDs) where the sonography failed. Moreover, the CT scan shows the exact extent of the degree of inflammation in order to be able to accurately plan any surgical intervention[ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, removing the appendix was also useful for two reasons. First, there was a “contiguous appendicitis” secondary to diverticular inflammation[ 15 , 25 ] and second because the removal of the appendix would have allowed a simpler diagnosis in case of a new episode of pain in the right iliac fossa[ 19 , 22 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Right sided diverticulitis in western countries: A review

Epifani¹,

Cassini²,

Cirocchi³

et al. 2021

WJGS

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BACKGROUND Although the treatment guidelines for left sided diverticulitis are clear, the management of right colonic diverticulitis is not well established. This disease can no longer be ignored due to significant spread throughout Asia. AIM To analyse epidemiology, diagnosis and treatment of right-sided diverticulitis in western countries. METHODS MEDLINE and PubMed searches were performed using the key words “right-sided diverticulitis’’, ‘‘right colon diverticulitis’’, ‘‘caecal diverticulitis’’, ‘‘ascending colon diverticulitis’’ and ‘‘caecum diverticula’’ in order to find relevant articles published until 2021. RESULTS A total of 18 studies with 422 patients were found. Correct diagnosis was made only in 32.2%, mostly intraoperatively or via CT scan. The main reason for misdiagnosis was a suspected acute appendicitis (56.8%). The treatment was a non-operative management (NOM) in 184 patients (43.6%) and surgical in 238 patients (56.4%), seven of which after NOM failure. Recurrence rate was low (5.45%), similar to eastern studies and inferior to left -sided diverticulitis. Recurrent patients were successfully conservatively retreated in most cases . CONCLUSION The management of right- sided diverticulitis is not well clarified in the western world and no selective guidelines have been considered even if principles are similar to those with left- sided diverticulitis. Wrong diagnosis is one of the most important problems and CT scan seems to be the best imaging modality. NOM offers a safe and effective treatment; surgery should be considered only in cases of complicated diverticulitis or if malignancy cannot be excluded. Further studies are needed to clarify the correct treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Right sided diverticulitis in western countries: A review

Epifani¹,

Cassini²,

Cirocchi³

et al. 2021

WJGS

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“…For treatment of uncomplicated diverticulitis (without phlegmon, abscess, perforation, or fistula [ 1 ]) conservative medical management with IV antibiotics is preferred in both children and adults. Surgery is reserved for those with complicated diverticulitis, those that are hemodynamically unstable, or for recurrence of disease [ 9 ]. However, because there is such a high rate of preoperative diagnosis of acute appendicitis, surgery often occurs without this determination.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic diverticulectomy with appendectomy is the preferred surgical approach in children and adults. Appendectomy should be performed at the same time in order to avoid misdiagnosis if right lower quadrant pain were to recur in the future [ 9 ]. Although a laparoscopic approach is favored, should the lesion not be identified then an open approach is warranted.…”

Section: Discussionmentioning

confidence: 99%

Congenital cecal diverticulitis in a pediatric patient

Lee

Albright

Brown

et al. 2021

Journal of Pediatric Surgery Case Reports

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Diverticulitis in the pediatric population is a very rare cause of abdominal pain. When present in the cecum or ascending colon, it is often incorrectly diagnosed preoperatively as acute appendicitis. This is especially true in Western countries where right-sided diverticulitis is less common. Here we detail a case of a pediatric patient with complicated congenital cecal diverticulitis and review the literature on pertinent management. An extensive work up with imaging and endoscopy was completed and definitive surgical treatment with diverticulectomy an appendectomy was performed. As the incidence of diverticular disease in younger individuals increases, right sided diverticulitis is worthy of consideration on the differential diagnosis.

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Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center

Jedidi,

Mabrouk,

Ghali

et al. 2024

World j. surg.

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PurposeRight‐sided diverticulitis is a rare entity in North Africa. Therefore, it is usually misdiagnosed, and the management of cecal diverticulitis is aggressive in most cases, whereas nowadays, most studies recommend a conservative approach with promising results. This study aims to describe the presentation, management, and outcomes of right‐sided diverticulitis (RSD) and to present the experience of one surgical center in Tunisia.MethodsThis is a retrospective study including all patients presented with RSD, in the Department of Surgery “A” of the Charles Nicolle Hospital between 2007 and 2021.ResultsForty patients were included in our study. The mean age was 42 years with a standard deviation of 14. The sex ratio was 1.1. Only 2 patients had chronic constipation. All patients presented right‐sided abdominal pain, and only 3 patients had diarrhea. Twenty one patients were diagnosed during surgery. Fourteen patients were treated successfully by conservative management. An operative procedure was performed in 26 cases: 21 had a diverticulectomy (80%), two had an ileal resection (8%), and three had a right colectomy (11.5%). No postoperative events occurred with a short hospital stay (5 ± 3 days). Follow‐up showed no recurrences.ConclusionRight‐sided diverticulitis has a lower incidence and complication rate compared to left‐sided diverticulitis. Conservative treatment has demonstrated favorable outcomes in managing RSD, although the available evidence remains limited.

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Solitary caecal diverticulitis; comparison of operative and non-operative treatment

Cited by 3 publications

References 0 publications

Right sided diverticulitis in western countries: A review

Right sided diverticulitis in western countries: A review

Congenital cecal diverticulitis in a pediatric patient

Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center

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