Lesson from a Cecal Phlegmon: From an Acute Appendicitis to a Solitary Cecal Diverticulitis

Abstract

A cecal phlegmon can be a difficult situation for a surgeon, since the treatment strategy must be decided with uncertainty of the phlegmon's origin: benign or malignant. The most common causes are cecal diverticulitis, acute appendicitis and cecal carcinoma. More rarely, it can be caused by a appendicular diverticulitis (1). In this case, we present a case of a cecal diverticulum, which is a rare but benign medical condition, in a 52-year-old man who presented to the emergency department with a 3-day constant abdominal pain in the right lower quadrant with rebound and with an increase of the inflammatory analytical levels. An abdominal ultrasound showed findings compatible with an acute appendicitis and the patient was proposed to a laparoscopic appendectomy. Intraoperatively, a cecal phlegmon was found and an ileocecal resection with primary anastomosis was conducted. Histopathological findings confirmed a rare solitary cecum diverticulitis.