Not Every Right Iliac Fossa Pain Is Appendicitis: A Case Report of Solitary Caecal Diverticulitis

Caecal diverticulitis is an uncommon condition in western countries and is often confused with the diagnosis of acute appendicitis. A distinction between the two entities is almost made intraoperatively. The management of solitary inflamed caecal diverticulae is still controversial; it ranges from a conservative approach with antibiotics to a right hemicolectomy. We present a case of 27 year old female which presented to the emergency department with symptoms similar to acute appendicitis. However, a CT scan showed signs of perforated caecal diverticulitis, thus an ileocaecal resection was realized. Across our case and a literature review, we try to highlight the difficulty of a preoperative diagnosis of this rare clinical condition and to discuss essentially its surgical management.

[1]  Feraas Jabi,et al.  Perforated cecal diverticulitis with CT diagnosis and medical management , 2018, Radiology case reports.

[2]  Y. Chou,et al.  Right-Sided Colonic Diverticulitis: Clinical Features, Sonographic Appearances, and Management , 2017, Journal of medical ultrasound.

[3]  S. Naidu,et al.  Caecal diverticulitis: Presentation and management☆ , 2015, Annals of medicine and surgery.

[4]  W. Law,et al.  Emergency surgery for colonic diverticulitis: differences between right-sided and left-sided lesions , 2001, International Journal of Colorectal Disease.

[5]  K. Tan,et al.  Non-operative treatment of right-sided colonic diverticulitis has good long-term outcome: a review of 226 patients , 2013, International Journal of Colorectal Disease.

[6]  A. Karip,et al.  Therapy of Solitary Cecal Diverticulitis in a Young Patient With Laparoscopic Right Hemicolectomy , 2011, Surgical laparoscopy, endoscopy & percutaneous techniques.

[7]  A. Ayantunde,et al.  Caecal diverticulitis presenting as acute appendicitis: a case report , 2009, World journal of emergency surgery : WJES.

[8]  M. Kurer Solitary caecal diverticulitis as an unusual cause of a right iliac fossa mass: a case report , 2007, Journal of medical case reports.

[9]  B. Siewert,et al.  Impact of CT-guided drainage in the treatment of diverticular abscesses: size matters. , 2006, AJR. American journal of roentgenology.

[10]  R. Chen,et al.  Aggressive resection is indicated for cecal diverticulitis. , 2003, American journal of surgery.

[11]  P. Chiu,et al.  Conservative approach is feasible in the management of acute diverticulitis of the right colon , 2001, ANZ journal of surgery.

[12]  Y. Chou,et al.  Sonography of acute right side colonic diverticulitis. , 2001, American journal of surgery.

[13]  R. Poon,et al.  Inflammatory Cecal Masses in Patients Presenting with Appendicitis , 1999, World Journal of Surgery.

[14]  R. Flückiger,et al.  [Diverticulitis of the cecum and ascending colon]. , 1998, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[15]  A. Rauff,et al.  Surgical management of right colon diverticulitis , 1992, Diseases of the colon and rectum.

[16]  R. Zollinger,et al.  Diverticulitis of the cecum and ascending colon. , 1961, Archives of surgery.