Espinosa James, Sharma Rahul, Lucerna Alan, Stranges Doug
Department of Emergency Medicine, Rowan University-SOM/Kennedy University Hospital, Stratford, NJ, USA.
Department of Surgery, Rowan University-SOM/Kennedy University Hospital, Stratford, NJ, USA.
Case Rep Emerg Med. 2017;2017:2563218. doi: 10.1155/2017/2563218. Epub 2017 Oct 2.
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.
我们报告一例71岁女性病例，该患者因右下腹部疼痛就诊，CT扫描诊断为右侧憩室炎伴穿孔。经会诊后收入外科治疗，根据需要接受静脉输液、静脉抗生素治疗及止痛药物。患者入院2天后病情稳定出院，并转至胃肠病科进行随访。右下腹部疼痛的鉴别诊断范围广泛。右侧憩室炎的表现通常与阑尾炎相似。在无腹膜炎的情况下，保守治疗可能可行。可以预见，随着人口老龄化，右侧憩室病的发病率将会增加，导致更多急性右侧憩室炎患者前往急诊科就诊。本病例报告的目的是提高急诊医生对右侧憩室炎的发病率、病理生理学、表现、检查（实验室检查和影像学检查）及治疗（药物治疗和手术治疗）的认识。
