Maya MZC, Padrón AG

Language: Spanish
References: 0
Page: 125-127
PDF size: 126.45 Kb.

ABSTRACT

Objective: To present a case of cecal diverticulitis and the therapeutic decision taking implied in its diagnosis.
Setting: Hospital Integral Playa del Carmen, Q. Roo., Mexico.
Design: Case presentation.
Description of the case: A 23-year-old man that came to the emergency ward due to colic-type diffuse abdominal pain. Based on the diagnostic suspicion of acute appendicitis it was decided to perform surgery, finding an inflammatory lesion of approximately 1 cm with an erythematous halo in the anterior side of the cecum, approximately at 2 cm of the ileocecal valve without evident perforation. Right hemicolectomy and primary ileocolic termino-terminal in two planes anastomosis was performed. The patient was discharged on the 5th post-surgery day and evolving well. The histopathological study of the specimen revealed the presence of a secondary acute peri-appendicitis, inflammed cecal diverticulus with an impacted fecal stone and acute reactive peritonitis.
Conclusion: The inflammatory process is caused by a fecal stone. Differential diagnosis, aside from appendicits, must include regional enteritis, Meckel’s diverticulitis, perforation due to carcinoma, amebic colitis, inflammatory pelvic disease. In our patient, it was decided to perform an intestinal resection because we had diagnostic doubts and being in a favorable scenario for this decision since evolution time was short, with neither macroscopic perforation, abscesses nor data of disseminated peritonitis, with a healthy appendix, and a young patient.