Solitary Cecal Diverticulitis: An Unusual Cause of Acute Right Iliac Fossa Pain—A Case Report and Review of the Literature

Abstract

Solitary cecal diverticulitis is a rare cause of acute abdominal pain in the Western world. Its clinical presentation, in most cases, mimics acute appendicitis. A 38-year-old Caucasian man presented with acute abdomen and clinical signs of acute appendicitis. Laparotomy was performed and revealed an inflammatory, solitary diverticulum of the cecum. A typical appendectomy was performed and a catheter was inserted for draining percutaneously the inflamed diverticulum of the cecum. The patient had an uneventful recovery and was discharged on the 4th postoperative day. This frequently misdiagnosed condition, in most cases, is being suspected and identified intraoperatively as acute appendicitis. The aim of this study is to review the available different surgical management options and to present an alternative therapeutic approach that may be valuable under specific circumstances.

Synchronous acute appendicitis, perforated caecal diverticulitis and serrated adenoma of right-sided colon: An uncommon incidental finding

“…If a solitary cecal diverticulum is clearly identified at the time of surgery, some authors advocate no intervention, while others recommend a simple diverticulectomy, or at least invagination of the diverticulum combined with appendectomy. [12] In the presence of marked inflammatory changes or complications, such as free perforation, torsion, or localized abscess formation, ileocecal resection or right hemicolectomy should be considered. [13] Yang et al, [14] reported that if perioperative malignancy was suspected, right hemicolectomy is the treatment of choice.…”

Solitary caecum diverticulitis mimicking acute appendicitis

“…Treatment of CD is still controversial, varying from conservative therapy to aggressive surgery. [6,15,16] There is no consensus among surgeons as to the best option. There are studies recommending conservative medical treatment or only diverticulectomy, if technically possible, for the treatment of CD cases, and these studies havereported that excisional treatment prevent the relapse of the symptoms.…”

“…There are studies recommending conservative medical treatment or only diverticulectomy, if technically possible, for the treatment of CD cases, and these studies havereported that excisional treatment prevent the relapse of the symptoms. [15] In the presence of excess inflammatory changes, multiple diverticulum and caecal phlegmon or if cancer cannot be excluded; aggressive resection like right hemicolectomy should be considered. Because, in these patients, surgical treatment can be applied safely without any major complication.…”

“…Because, in these patients, surgical treatment can be applied safely without any major complication. [8,15] Laparoscopic or open surgical procedures may be performed. In 1994, the first laparoscopic diverticulectomy was performed.…”

Cecal diverticulitis mimicking acute appendicitis

“…Treatment of cecal diverticulitis is still controversial, varying from conservative therapy to aggressive surgery, such as right hemicolectomy [9]. Conservative management of cecal diverticulitis may be an effective treatment modality in cases diagnosed with imaging techniques.…”