title: A rare nosological entity: the perforated solitary cecal diverticulum. Research article.
abstract: OBJECTIVE
  To describe three cases of solitary cecal diverticulum, and trying to evaluate the better method of diagnosis and treatment with analysis of the literature.
  
  
  METHODS
  Description of three cases of solitary cecal diverticulum's perforation admitted in the Department of General and Oncologic Surgery, Santa Maria della Misericordia Hospital, Perugia, during the period January 2011 - January 2012.
  
  
  RESULTS
  In all patients the clinical presentation was very similar to that of acute appendicitis. Preoperative diagnosis was achieved in one case through abdominal CT scan, other two cases were identified at final pathology. At one year from the treatment all patient are still alive.
  
  
  CONCLUSIONS
  Cecal diverticulum is a rare condition, often diagnosed either casually or because of inflammatory or perforative complications. The highest incidence is found in Western population. Because of the clinical presentation, very similar to the appendicitis, and the inflammatory reaction involving the colon and its surrounding tissues, the pre- and intra-operative diagnosis are very difficult. The diagnosis is almost always histological. The treatment may vary from simple expectant medical management, carried out with bowel rest, parenteral support and antibiotics as for left-sided diverticulitis, to surgical approach, performed through simple diverticulectomy or by classical right hemicolectomy.
  
  
  CONCLUSIONS
  Pre-surgical and, also intra-operative, diagnosis of perforated solitary cecal diverticulum is clearly difficult. CT scan represents the gold standard for the differential diagnosis. Right hemicolectomy is an effective and safe approach, allowing accurate control, preventing complications and recurrences, and it represents the optimal management of the disease.
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.forename: Gloria
authors.initials: G
authors.lastname: Burini
authors.forename: Piero
authors.initials: P
authors.lastname: Covarelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Barberini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gemini
authors.forename: Elisa
authors.initials: E
authors.lastname: Castellani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
mesh_terms: D000328:Adult; D001064:Appendicitis / Q000175:diagnosis; D002429:Cecal Diseases / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004240:Diverticulum / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged