Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckst. 1, 55131, Mainz, Germany.
Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Int J Colorectal Dis. 2019 Jul;34(7):1333-1336. doi: 10.1007/s00384-019-03301-6. Epub 2019 May 14.
Cecal diverticulitis is a rare entity causing right iliac fossa pain. Its symptoms may mimic acute appendicitis. Therefore, the majority of these patients undergo unnecessary surgery for suspected diagnosis of appendicitis.
We report a case series of solitary cecal diverticulitis, right-sided colonic diverticulitis, and perforated cecal diverticulitis diagnosed by computed tomography scan.
The first two cases were successfully managed conservatively with intravenous antibiotics, rehydration, and temporary bowel rest. The third case developed a retroperitoneal abscess, which was initially drained under computed tomography guidance. However, due to development of septicemia, the patient underwent urgent right hemicolectomy. All patients recovered and were discharged during the further course.
Computed tomography is of great value for the diagnosis of cecal diverticulitis and its differentiation from acute appendicitis. Conservative treatment is sufficient in uncomplicated cases, while surgery is reserved for those with associated large abscess or free perforation.
盲肠憩室炎是一种罕见的疾病，可引起右髂窝疼痛。其症状可能类似于急性阑尾炎。因此，大多数患者因疑似阑尾炎而行不必要的手术。
我们报告了一组经计算机断层扫描诊断的孤立性盲肠憩室炎、右侧结肠憩室炎和穿孔性盲肠憩室炎的病例系列。
前两例患者经静脉注射抗生素、补液和暂时禁食保守治疗成功。第三例患者发展为腹膜后脓肿，最初在计算机断层扫描引导下进行引流。然而，由于败血症的发展，患者接受了紧急右半结肠切除术。所有患者在进一步治疗过程中均康复并出院。
计算机断层扫描对盲肠憩室炎及其与急性阑尾炎的鉴别诊断具有重要价值。在无并发症的情况下，保守治疗是足够的，而对于伴有大脓肿或游离穿孔的患者，则保留手术治疗。
