title: Intraoperative diagnosis of cecal diverticulitis during surgery for acute appendicitis: Case series.
abstract: OBJECTIVE
  Cecal diverticulum is a rare entity, and can cause acute abdomen by the way of diverticulitis and perforation of diverticulitis. In this study, we aimed to perform an analysis of patients that have cecal diverticulitis, and presented with acute abdomen.
  
  
  METHODS
  Patients who were admitted to emergency clinic between 2009-2012 and had acute abdomen due to cecal diverticulitis were included into study retrospectively.
  
  
  RESULTS
  Six patients were included in the study with a mean age of 34 years (range 24-43). Four patients were male and two were female (male/female: 2). All six patients presented with abdominal pain, additional symptoms were nausea in five patients, and vomiting in one patient. The mean white blood cell count was 11.900/mm(3) (5850-17.400/mm(3)), while the remaining laboratory results were normal. There were no specific findings on abdominal X-ray or ultrasonography. The surgical exploration revealed an inflamed cecal diverticulitis and normal appendix in all patients. Five patients underwent appendectomy and diverticulectomy. Right hemicolectomy was performed in one patient due to suspicion of malignancy. The early postoperative period was uneventful in all patients. The mean length of hospital stay was 4.5 days with a range of 2-6 days. Histopathological examination showed acute perforated diverticulitis with underlying true diverticulum in three patients, and true diverticulum with acute diverticulitis in the remaining three patients.
  
  
  CONCLUSIONS
  Pre-operative diagnosis of cecal diverticulitis is challenging due to symptoms and signs that resemble acute appendicitis. Diverticulectomy and incidental appendectomy is the treatment of choice in uncomplicated cases.
authors.affiliation: Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Kalcan
authors.affiliation: Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Başak
authors.affiliation: Department of General Surgery, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hasbahçeci
authors.affiliation: Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Kılıç
authors.affiliation: Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Canbak
authors.affiliation: Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: İlyas
authors.initials: İ
authors.lastname: Kudaş
authors.affiliation: Clinic of General Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Gürhan
authors.initials: G
authors.lastname: Baş
authors.affiliation: Department of General Surgery, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Alimoğlu
keywords: Cecum; acute abdomen; acute appendicitis; diverticulitis