Murillo ZA, Belmonte MC, Guerrero GVH, Cosme RC, Murakami MPD

Language: Spanish
References: 13
Page: 192-195
PDF size: 76.18 Kb.

ABSTRACT

Objective: We present a case of cecal diverticulitis diagnosed through CAT scan, which was managed with laparoscopic assisted ileo-colic resection. Setting: Third level health care hospital (ABC medical center). Design: Case report. Description of the case: Male patient, 37-year-old, who started 18 h before with oppressive abdominal pain, in the epigastrium, which later turned diffuse, intensity 7/10, constant, accompanied by non-quantified fever, chills, and intense nausea without vomitting. He referred having had a similar condition 6 months before. Physical exploration revealed painful abdomen to deep palpation in the right hypochondrium and epigastrium with negative rebound. Tests revealed leukocytosis. The TAC scan revealed an inflamed cecal diverticulum. He was subjected to a laparoscopic assisted ileo-colic resecction. The post-operative period was uneventful and he was discharged in good conditions. Conclusion: The diagnosis of cecal diverticulitis is rare. It is an uncommon entity and its clinical presentation is suggestive of acute appendicitis. TAC scan enables a differential diagnosis. Laparoscopy-assisted treatment can be a feasible alternative, which provides the benefits of a faster recovery, a better cosmetic result, and a faster return to daily activities.

REFERENCES

1. Chiu JH, Lin JT, Lin JK, Leu SY, Lian CL, Wang FM. Diverticular disease of the colon. J Surg Asso 1987; 20: 102-108.

2. Papaziogas B, Makris J, Koutelidakis I, Paraskevas G, Oigonomou B, Papadopoulos E, et al. Surgical management of cecal diverticulitis: Is diverticulectomy enough? Int J Colorectal Dis 2005; 20: 24-27.

3. Telem Dana A. Buch KE, Nguyen SQ, Chin EH, Weber KJ, Divino CM. Current recommendations on diagnosis and management of right-sided diverticulitis. Gastroenterol Res Pract 2009; 2009: 359485. Epub 2009 Mar 24.

4. Oudenhoven LF, Koumans RK, Puylaert JB. Right Colonic diverticulitis: US and CT findings — new insights about frequency and natural history. Radiology 1998; 208: 611-618.

5. Lane JS, Sarkar R, Schmit PJ, Chandler CF, Thompson JE Jr. Surgical approach to cecal diverticulitis. J Am Coll Surg 1999; 188: 629-634.

6. Fang JF, Chen RJ, Lin BC, Hsu YB, Kao JL, Chen MF. Aggressive resection is indicated for cecal diverticulitis. Am J Surg 2003; 185: 135-140.

7. Yang HR, Huang HH, Wang YC, Hsieh CH, Cheng PK, Jeng LB, et al. Management of right colon diverticulitis: A 10 year experience. World J Surg 2006; 30: 1929-1934.

8. Connolly D, McGookin RR, Gidwani A, Brown MG. Inflamed solitary caecal diverticulum – it is not appendicitis, what should I do? Ann R Coll Surg Engl 2006; 88: 672-674.

9. Li JC, Ng SS, Lee JF, Yiu RY, Hon SS, Leung WW, Leung KL. Emergency laparoscopic-assisted versus open right hemicolectomy for complicated cecal diverticulitis: a comparative study. J Laparoendosc Adv Surg Tech A 2009; 19: 479-83

10. Komuta K, Yamanaka S, Okada K, Kamohara Y, Ueda T, Makimoto N, et al. Toward therapeutic guidelines for patients with acute right colonic diverticulitis. Am J Surg 2004; 187: 233-237.

11. Ngoi SS, Chia J, Goh MY, Sim E, Rauff A. Surgical management of right colon diverticulitis. Dis Colon Rectum 1992; 35: 799-802.

12. Lo CY, Chu KW. Acute diverticulitis of the right colon. Am J Surg 1996; 171: 244-246.

13. Schwenk W, Haase O, Neudecker J, Müller JM. Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev 2005; 20: CD003145.