Cecal diverticulitis.
Cecal diverticulitis is an uncommon entity. Its operative treatment represents 0.2% of procedures performed for an acute abdomen. The clinical presentation is often indistinguishable from acute appendicitis. At operation, it may be confused with cecal carcinoma. The surgeon must be aware of this condition and be prepared to choose the most appropriate treatment. Local excision has been advocated as the treatment of choice. The authors review 18 cases seen over a 10-year period. In no case was the correct diagnosis made preoperatively. Intraoperatively, a correct diagnosis was made in 12 of the 18. Carcinoma was the next most frequent intraoperative diagnosis (four cases). Twelve of the 18 patients were treated by standard or limited right hemicolectomy. One patient died early in the series of sepsis caused by a perforated diverticulum and one patient had a life-threatening complication. Right hemicolectomy appears to be a safe and effective treatment option for cecal diverticulitis.
Luoma
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Department of Surgery, University of British Columbia, Vancouver General Hospital.
Nagy
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AG
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000175:diagnosis; D002429:Cecal Diseases / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003082:Colectomy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004238:Diverticulitis / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D004630:Emergencies; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies