title: Perforation of the sigmoid colon simulating acute appendicitis.
abstract: Diverticulitis and carcinoma with abscess formation following perforation of the redundant sigmoid colon was erroneously diagnosed as acute appendicitis in nine patients over a period of five years. As te inflammatory process develops in the right lower quadrant of the abdomen, lack of previous colonic pathology may lead to a misdiagnosis, usually of acute appendicitis. It should be borne in mind, however, that acute appendicitis decreases with age, whereas diverticula and carcinomas increase, and that the sigmoid colon is often a redundant organ with a tendency to migrate to the right side of the abdomen. In elderly patients with acute right abdominal pathology, it is important to operate through a transrectal or paramedian incision. A two-stage operation is preferable to a three-stage one.
mesh_terms: D000038:Abscess / Q000209:etiology; D001064:Appendicitis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000150:complications; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000175:diagnosis*; D012811:Sigmoid Neoplasms / Q000150:complications