Cecal diverticulitis: a diagnostic challenge
| Autor: | Yehuda Shperber, Ruben Orda, Itzhak Pappo, Sergey Keidar |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment MEDLINE Diverticulitis Colonic Cecum Laparotomy medicine Carcinoma Cecal Diseases Humans Digestive System Surgical Procedures Aged Retrospective Studies business.industry General surgery Gastroenterology Retrospective cohort study Diverticulitis Middle Aged medicine.disease Surgery medicine.anatomical_structure Acute appendicitis Female business Colonic surgery |
| Zdroj: | Digestive surgery. 17(5) |
| ISSN: | 0253-4886 |
| Popis: | Background: Cecal diverticulitis is frequently indistinguishable from acute appendicitis preoperatively and is sometimes mistaken for carcinoma at laparotomy. The surgeon must be aware of the possibility of diverticulitis of the cecum in the operating room and choose the appropriate treatment. Purpose: Because there is no universal therapeutic approach to these patients, we decided to assess the presenting symptoms, clinical findings, preoperative diagnosis, operative findings determining the proper management of these patients. Methods: A retrospective chart review of 13 patients with pathologically confirmed cecal diverticulitis, who underwent surgery in our department from 1984 to 1998, was undertaken. Results: The mean age of patients was 43.5 years. Right lower quadrant pain and local tenderness were the only clinical findings in 92.3%, with preoperative diagnosis of acute appendicitis in 84.6% of patients. The operative finding in most cases was inflammatory mass of the cecum; in 6 cases it was indistinguishable from perforated cecal carcinoma. Six patients underwent right hemicolectomy, 5 had ileocecectomy, 1 patient was treated by tube cecostomy, and 1 had diverticulectomy. There were three minor postoperative complications: pneumonia, wound infection and lower limb superficial thrombophlebitis. Conclusions: Cecal diverticulitis needs a high index of suspicion for achieving a preoperative diagnosis. We suggest that the operative therapy should be ileocecectomy. The surgical specimen should be examined during surgery and only if carcinoma is found should the patient have a formal colectomy. |
| Databáze: | OpenAIRE |
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