Department of Surgery, Queen Mary's Hospital, Frognal Avenue, Sidcup, Kent, DA14 6LT, UK.
World J Emerg Surg. 2009 Jul 31;4:29. doi: 10.1186/1749-7922-4-29.
Solitary caecal diverticulum is an uncommon entity and therefore difficult to diagnose except at surgery. Caecal diverticulitis is an infrequent cause of acute abdomen and usually presents in a manner similar to acute appendicitis. It is extremely difficult to differentiate it preoperative from acute appendicitis and such distinction is usually made in the operating room. The optimal management of this clinical condition is still controversial, ranging from conservative treatment with antibiotics to aggressive surgical resections.We report a case of a 61 year old Caucasian who presented with acute onset right iliac fossa pain indistinguishable from acute appendicitis. The true diagnosis of a perforated acute caecal diverticulitis with an abscess mass was only made at operation in the presence of a macroscopically normal appendix. We reviewed the literature to highlight the difficulty of a preoperative diagnosis and the need for a high index of suspicion especially in the older age group presenting in manner similar to acute appendicitis.
孤立性盲肠憩室是一种罕见的疾病，因此除了手术之外，很难在术前进行诊断。盲肠憩室炎是急性腹痛的不常见原因，通常表现为类似于急性阑尾炎的方式。术前很难将其与急性阑尾炎区分开来，通常是在手术室中进行区分。这种临床情况的最佳治疗方法仍存在争议，范围从抗生素的保守治疗到积极的手术切除。我们报告了一例 61 岁的白人患者，他表现为突发性右髂窝疼痛，与急性阑尾炎无法区分。只有在阑尾外观正常的情况下，在手术中才能真正诊断出穿孔性急性盲肠憩室炎合并脓肿。我们回顾了文献，强调了术前诊断的困难以及特别是在表现类似于急性阑尾炎的老年患者中，需要高度怀疑的必要性。
