General Surgery Department, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Department of General Surgery, Sakarya University Research and Educational Hospital, Adapazarı, Turkey.
Pol Przegl Chir. 2021 Mar 16;93(4):15-20. doi: 10.5604/01.3001.0014.8057.
<b> Objective: </b> Cecal diverticulitis may be encountered as a real etiological factor in 1/300 appendectomies. Differential diagnosis of acute appendicitis and cecal diverticulitis is crucial because of the different treatment methods. Our aim is to reveal the importance of distinguishing acute appendicitis from cecal diverticulitis. <p> <b>Methods: </b> The data of patients who were admitted to the hospital between 2015 and 2019 with the complaint of abdominal pain and then finally diagnosed with colon diverticular disease, colon diverticulitis, or acute appendicitis, analyzed retrospectively. <p><b>Results: </b> A total of 19 cecum diverticulitis patients were detected during surgery for acute appendicitis or during clinical and radiological evaluation. 1247 appendectomies were evaluated; the final diagnosis was observed as cecal diverticulitis in 5 patients (0,4%). One hundred nineteen patients diagnosed with colonic diverticulitis at admission were evaluated, while 105 (88,2%) of them had left-sided diverticulitis, 14 (11,7%) of them had solitary cecal diverticulitis. All of the solitary cecal diverticulitis patients were treated conservatively, except one patient who has Hinchey 3 diverticulitis.<p><b> Conclusion: </b> Differential diagnosis of cecum diverticulitis with acute appendicitis is important because cecum diverticulitis can be managed as conservatively in most cases. In order to prevent unnecessary surgical interventions, this importance has increased, especially during the COVID-19 pandemic period.
盲肠憩室炎在 1/300 例阑尾切除术中可能是一个真正的病因。急性阑尾炎和盲肠憩室炎的鉴别诊断很重要,因为治疗方法不同。我们的目的是揭示区分急性阑尾炎和盲肠憩室炎的重要性。
回顾性分析了 2015 年至 2019 年间因腹痛入院并最终诊断为结肠憩室病、结肠憩室炎或急性阑尾炎的患者数据。
在急性阑尾炎手术或临床和影像学评估中发现 19 例盲肠憩室炎患者。共评估了 1247 例阑尾切除术,其中 5 例(0.4%)最终诊断为盲肠憩室炎。入院时诊断为结肠憩室炎的 119 例患者进行了评估,其中 105 例(88.2%)为左侧憩室炎,14 例(11.7%)为孤立性盲肠憩室炎。所有孤立性盲肠憩室炎患者均接受保守治疗,除 1 例 Hinchey 3 级憩室炎患者外。
急性阑尾炎与盲肠憩室炎的鉴别诊断很重要,因为大多数情况下盲肠憩室炎可以保守治疗。为了避免不必要的手术干预,特别是在 COVID-19 大流行期间,这种重要性增加了。