Perforated diverticulum of the caecum. A difficult preoperative diagnosis. Report of 2 cases and review of the literature.
BACKGROUND
Perforation of a solitary caecal diverticulum is a rare cause of acute abdomen and an uncommon differential diagnosis for acute appendicitis. Nine hundred cases have been described since Potiers' first description of perforated caecal diverticulum in 1912.


METHODS
We describe 2 cases of perforated diverticulum of the caecum. The first patient was a 50-year-old man diagnosed by subsequent histology, and the second a 77-year-old woman diagnosed intra-operatively. Radiography, ultrasound and CT scan of the abdomen pointed at the diagnosis in the second case. A right hemicolectomy was performed.


RESULTS
There were no complications, apart from a transient faecal fistula in the first patient managed conservatively. In both patients histology revealed a perforated caecal diverticulum.


CONCLUSIONS
The surgeon must be familiar with the diagnosis and management of this rare, inflammatory benign caecal entity.
Papapolychroniadis
C
C
Komninon 68, 55132 Kalamaria, Greece. jimkam@med.auth.gr
Kaimakis
D
D
Fotiadis
P
P
Karamanlis
E
E
Stefopoulou
M
M
Kouskouras
K
K
Dimitriadis
A
A
Harlaftis
N
N
D000368:Aged; D002429:Cecal Diseases / Q000175:diagnosis* / Q000601:surgery; D003082:Colectomy / Q000379:methods; D003952:Diagnostic Imaging / Q000379:methods*; D004241:Diverticulum, Colon / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler