Kalcan Süleyman, Başak Fatih, Hasbahçeci Mustafa, Kılıç Ali, Canbak Tolga, Kudaş İlyas, Baş Gürhan, Alimoğlu Orhan
Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Department of General Surgery, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey.
Ulus Cerrahi Derg. 2015 Jun 24;32(1):54-7. doi: 10.5152/UCD.2015.2765. eCollection 2016.
Cecal diverticulum is a rare entity, and can cause acute abdomen by the way of diverticulitis and perforation of diverticulitis. In this study, we aimed to perform an analysis of patients that have cecal diverticulitis, and presented with acute abdomen.
Patients who were admitted to emergency clinic between 2009-2012 and had acute abdomen due to cecal diverticulitis were included into study retrospectively.
Six patients were included in the study with a mean age of 34 years (range 24-43). Four patients were male and two were female (male/female: 2). All six patients presented with abdominal pain, additional symptoms were nausea in five patients, and vomiting in one patient. The mean white blood cell count was 11.900/mm(3) (5850-17.400/mm(3)), while the remaining laboratory results were normal. There were no specific findings on abdominal X-ray or ultrasonography. The surgical exploration revealed an inflamed cecal diverticulitis and normal appendix in all patients. Five patients underwent appendectomy and diverticulectomy. Right hemicolectomy was performed in one patient due to suspicion of malignancy. The early postoperative period was uneventful in all patients. The mean length of hospital stay was 4.5 days with a range of 2-6 days. Histopathological examination showed acute perforated diverticulitis with underlying true diverticulum in three patients, and true diverticulum with acute diverticulitis in the remaining three patients.
Pre-operative diagnosis of cecal diverticulitis is challenging due to symptoms and signs that resemble acute appendicitis. Diverticulectomy and incidental appendectomy is the treatment of choice in uncomplicated cases.
盲肠憩室是一种罕见的疾病，可通过憩室炎和憩室炎穿孔导致急腹症。在本研究中，我们旨在对患有盲肠憩室炎并表现为急腹症的患者进行分析。
回顾性纳入2009年至2012年间因盲肠憩室炎入住急诊诊所且患有急腹症的患者。
6例患者纳入研究，平均年龄34岁（范围24 - 43岁）。4例男性，2例女性（男/女：2）。所有6例患者均有腹痛，另外5例患者有恶心症状，1例患者有呕吐症状。平均白细胞计数为11,900/mm³（5850 - 17,400/mm³），其余实验室检查结果均正常。腹部X线或超声检查无特异性发现。手术探查显示所有患者均有炎症性盲肠憩室炎且阑尾正常。5例患者接受了阑尾切除术和憩室切除术。1例患者因怀疑恶性肿瘤而行右半结肠切除术。所有患者术后早期情况平稳。平均住院时间为4.5天，范围为2 - 6天。组织病理学检查显示3例患者为急性穿孔性憩室炎伴真性憩室，其余3例患者为真性憩室伴急性憩室炎。
由于症状和体征与急性阑尾炎相似，盲肠憩室炎的术前诊断具有挑战性。在无并发症的病例中，憩室切除术和附带阑尾切除术是首选治疗方法。
