Right-Sided Sigmoid Diverticular Perforation

Little, Andrew F.; Culver, Andrew

doi:10.5811/westjem.2011.4.6750

Cited by 4 publications

(12 citation statements)

References 10 publications

(14 reference statements)

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“…Most patients with diverticula of the right side are asymptomatic [ 6 ]. Right-sided diverticulitis presents with right lower quadrant abdominal, nausea, and vomiting as well as other symptoms and thus can mimic appendicitis [ 1 , 7 – 9 ]. Nirula and Greaney presented a series of 12 cases of right-sided diverticulitis over a 10-year period in a single hospital, in which the preoperative diagnosis of appendicitis was made in 11 cases.…”

Section: Discussionmentioning

confidence: 99%

“…An inflammatory colonic mass of uncertain etiology that is ultimately diagnosed as right-sided diverticulitis may have an initial working diagnosis of a carcinoma [ 8 ]. Complications of right-sided diverticulitis include “phlegmon, intra-abdominal abscess, fistulas involving adjacent organs, and distant septicemia” [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…CT scanning appears to be the best overall imaging modality in the diagnosis of possible right-sided diverticulitis [ 5 , 7 – 9 ]. “CT gives clinicians the most information about location and involvement of adjacent or distant organs or structures when compared to other imaging modalities” [ 7 ]. It was for this reason that a CT scan was used as the imaging modality of choice in this case.…”

Section: Discussionmentioning

confidence: 99%

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Medical Approach to Right Colon Diverticulitis with Perforation

Espinosa

Sharma

Lucerna

et al. 2017

Case Reports in Emergency Medicine

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We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast. Right-sided diverticulitis often presents in a manner similar to appendicitis. In the absence of peritonitis, conservative treatment may be possible. It is predictable that as the population ages, the incidence of right-sided diverticular disease will increase and will result in more presentations of acute right-sided diverticulitis to the emergency department (ED). The aim of this case report is to increase awareness of the incidence, pathophysiology, presentation, work-up (laboratory studies and imaging), and management (medical and surgical) of right-sided diverticulitis among emergency physicians.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Medical Approach to Right Colon Diverticulitis with Perforation

Espinosa

Sharma

Lucerna

et al. 2017

Case Reports in Emergency Medicine

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“…Therefore, we The CT images revealed variations in the anatomic positions of the descending colon and sigmoid colon as well as sigmoid diverticulitis. Unlike acute appendicitis, medical treatment is often sufficient to treat diverticulitis, although some cases might require surgery (8).…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis of acute abdominal pain should be made using appropriate imaging modalities, including ultrasound and CT. Ultrasound is a quick, easy, and relatively painless imaging technique, when performed by experienced users, to measure the size and content of abscesses. Ultrasound evaluation is a reliable method for the diagnosis of right-sided diverticulitis, with high sensitivity (91.3%) and specificity (99.5%) (7,8).…”

Section: Discussionmentioning

confidence: 99%

Sigmoid Diverticulitis Mimicking Acute Appendicitis in Right-Sided Descending and Sigmoid Colon: A Case Report

Gül¹,

Gül²,

Gönen³

et al. 2017

J Emerg Med Case Rep

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The patient had not previously undergone abdominal surgery and had no chronic diseases. Physical examination revealed local rebound tenderness over the ileocecal region, a temperature of 38°C, a heart rate ABSTRACT Introduction: Acute abdominal pain in the lower-right quadrant can be misdiagnosed as acute appendicitis and may be caused by anatomic variations of the intra-abdominal organs in rare cases. Anatomical variations in the position and morphology of the sigmoid colon should be considered by clinicians and radiologists to avoid misdiagnosis and unnecessary surgical procedures. Case Report: A 54-year-old man was admitted to our emergency department complaining of abdominal pain in the lowerright quadrant, nausea, vomiting, and fever for 2 days. Physical examination revealed local rebound tenderness on the lowerright quadrant and a temperature of 38°C. Abdominal ultrasound showed that the intestinal loops were thickened and the surrounding mesenteric tissue was edematous in the right abdominal quadrant. Abdominal computed tomography was performed after a bolus administration of intravenous contrast material, and sigmoid colon position anomalies and diverticulitis were observed. The patient was treated medically, and diverticulosis was confirmed by colonoscopy. Conclusion: Clinical evaluation and ordered appropriate imaging methods by the emergency specialist is important in patients with abdominal pain on the lower-right quadrant who are admitted to the emergency department. Thus, rare anatomical variations mimicking acute appendicitis can be diagnosed accurately, and patients can be protected from undergoing unnecessary surgeries.

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2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting

et al. 2020

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Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of acute left-sided colonic diverticulitis (ALCD) according to the most recent available literature. The update includes recent changes introduced in the management of ALCD. The new update has been further integrated with advances in acute right-sided colonic diverticulitis (ARCD) that is more common than ALCD in select regions of the world.

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Right-Sided Sigmoid Diverticular Perforation

Cited by 4 publications

References 10 publications

Medical Approach to Right Colon Diverticulitis with Perforation

Medical Approach to Right Colon Diverticulitis with Perforation

Sigmoid Diverticulitis Mimicking Acute Appendicitis in Right-Sided Descending and Sigmoid Colon: A Case Report

2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting

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