Annals of Coloproctology

Review

Right Colonic Diverticulitis: In Kyu Lee; J Korean Soc Coloproctol. 2010;26(4):241-245. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.241

5,098 View
71 Download
24 Citations

Although right colonic diverticultis (RCD) has been reported to be a rare disease in Western countries, RCD is a common diagnosis, with an incidence per 2.9-17 case of appendicitis, in Korea. Many Western studies have reported that it is difficult to differentiate the presenting symptoms of RCD from those of appendicitis before surgery because the signs and symptoms are similar. However, performing a computed tomography scan after the application of the diagnostic criteria for RCD has increased the preoperative RCD diagnostic rate. Treatment strategies have been difficult to define for this condition due to its low preoperative diagnosis rate. However, recent reports have shown that conservative medical treatment of uncomplicated RCD can be recommended and that such treatment is effective due to the benign and self-limited natural history of RCD. Therefore, in this review, we discuss the controversies surrounding RCD management.

Citations

Citations to this article as recorded by

Beyond the Norm: Acute Multifocal Diverticulitis
Bianca Thakkar, Jasmine Tidwell, Minh Thu T. Nguyen, Gengsheng Yu, Neil Parikh
ACG Case Reports Journal.2024; 11(9): e01505. CrossRef
Isolated Cecal Diverticulitis in a Non-Asian Patient With Strong Family History of Colon Adenocarcinoma
Reynold Henry, Benjamin Tam, Nicholas Serniak, Glenn Ault
The American Surgeon™.2023; 89(4): 1054. CrossRef
Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina
René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi
Annals of Coloproctology.2023; 39(2): 123. CrossRef
Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?
Lucas Faraco Sobrado, Tarsila Gomes Caldas, Carolina Graciolli Facanali, Leonardo Bustamente-Lopez, Carlos Walter Sobrado
Journal of Coloproctology.2022; 42(04): 302. CrossRef
Seeking outpatient management of right-sided diverticulitis
María Savoie-Hontoria, Rafael José Orti-Rodríguez, Miguel Ángel García Bello, Antonio Dámaso Pérez Álvarez, Manuel Ángel Barrera Gómez
European Surgery.2021; 53(6): 305. CrossRef
Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
Surgical Endoscopy.2020; 34(5): 2019. CrossRef
Diverticulitis aguda del ángulo hepático simulando un cuadro de colecistitis aguda
M. Gonzalez-Urquijo, A. Baca-Arzaga, G. Lozano-Balderas
Revista de Gastroenterología de México.2020; 85(4): 484. CrossRef
Acute diverticulitis of the hepatic flexure mimicking acute cholecystitis
M. Gonzalez-Urquijo, A. Baca-Arzaga, G. Lozano-Balderas
Revista de Gastroenterología de México (English Edition).2020; 85(4): 484. CrossRef
Perforated cecal diverticulitis with CT diagnosis and medical management
Caleb Tsetse, Shazia Rahat Chaudhry, Feraas Jabi, Jennifer Nicole Taylor
Radiology Case Reports.2019; 14(1): 30. CrossRef
Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study
L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
Journal of Visceral Surgery.2019; 156(4): 296. CrossRef
Résultats à long terme et prise en charge des diverticulites du colon droit dans les pays occidentaux : étude rétrospective multicentrique
L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
Journal de Chirurgie Viscérale.2019; 156(4): 322. CrossRef
Novel swine model of colonic diverticulosis
Xiaomei Guo, Bhavesh Patel, Ling Han, Hiba Al-Dulaimi, William G. Van Alstine, Jillian N. Noblet, Sean Chambers, Ghassan S Kassab
American Journal of Physiology-Gastrointestinal and Liver Physiology.2019; 317(1): G51. CrossRef
Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study
Yosuke Sasaki, Fumiya Komatsu, Naoyasu Kashima, Takahiro Sato, Ikutaka Takemoto, Sho Kijima, Tadashi Maeda, Takamasa Ishii, Taito Miyazaki, Yoshiko Honda, Nagato Shimada, Yoshihisa Urita
World Journal of Clinical Cases.2019; 7(12): 1393. CrossRef
A Rare Case of Acute Right-Sided Colonic Diverticulitis Presenting as Pancreatitis
Maria de Lourdes Ladino Sturchler, Evan A. Rusoja, Arun Nagdev, Barry C. Simon
The Journal of Emergency Medicine.2018; 54(4): e77. CrossRef
An Atypical Case of Transverse Diverticulitis and the Changing Management of Diverticular Disease
Andrew C. Ostosh, Adeeb Saleh, Kevin M. Boehm
Spartan Medical Research Journal.2018;[Epub] CrossRef
Right-Sided Colonic Diverticulitis: Clinical Features, Sonographic Appearances, and Management
Tse-Cheng Chiu, Yi-Hong Chou, Chui-Mei Tiu, Hong-Jen Chiou, Hsin-Kai Wang, Yi-Chen Lai, Yi-You Chiou
Journal of Medical Ultrasound.2017; 25(1): 33. CrossRef
Right-sided acute diverticulitis: A single Western center experience
Francesco Monari, Maurizio Cervellera, Basilio Pirrera, Umberto D'Errico, Samuele Vaccari, Laura Alberici, Valeria Tonini
International Journal of Surgery.2017; 44: 128. CrossRef
Acute Bowel Computed Tomography
Abdulmalik Dredar, Prem Thanaratnam, Kaiser Hussain, Seth Andrews, Edward Mtui, Tara Catanzano
Seminars in Ultrasound, CT and MRI.2017; 38(4): 399. CrossRef
Reste-t-il des indications pour la chirurgie à froid ?
B. Schiltz, C. Dumont, N. C. Buchs, Ph. Morel, F. Ris
Côlon & Rectum.2017; 11(1): 25. CrossRef
Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
Cirugía Española.2016; 94(10): 553. CrossRef
Diagnosis and Management of Right Colonic Diverticular Disease: A Review
Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
Cirugía Española (English Edition).2016; 94(10): 553. CrossRef
Evaluating Suspected Appendicitis
Winson Jianhong Tan, Hock Soo Ong
Journal of the American College of Surgeons.2015; 221(2): 635. CrossRef
Computed Tomography of Colonic and Appendiceal Emergencies
Vincent M. Mellnick, Christine O. Menias
Seminars in Roentgenology.2014; 49(2): 202. CrossRef
Diagnosis and Treatment of Colon Diverticulitis
Geom Seog Seo, Suck Chei Choi
Korean Journal of Medicine.2013; 85(6): 563. CrossRef

Original Articles

Management of Right Colon Diverticulitis.: Jang, Jong Ik , Lim, Yang Soo , Choi, Jong Woo , Lee, Yoon Sik; J Korean Soc Coloproctol. 2010;26(1):22-28.; DOI: https://doi.org/10.3393/jksc.2010.26.1.22

13,895 View
18 Download
4 Citations

Abstract PDF

PURPOSE
There are still many controversial aspects in the management of right colon diverticulitis. The aim of this study is to find an appropriate treatment for right colon diverticulitis.
METHODS
We retrospectively reviewed the medical records of 88 patients who were admitted with right colon diverticulitis to Wallace Memorial Baptist Hospital from January 2001 to December 2007.
RESULTS
The patients enrolled in this study included 52 men and 36 women. The mean age was 39.6 yr, ranging from 13 to 84 yr. Fifty-four of 88 patients underwent conservative treatment for right colon diverticulitis, and 34 of 88 patients underwent operative treatment. There were 5 cases of recurrence in the conservative treatment group, but there were no cases of recurrence in the operative treatment group. We experienced 43 cases with right colon diverticulitis at the operational fields, including 9 cases that underwent conservative treatment after an appendectomy: eleven cases that underwent conservative treatment after an appendectomy or an appendectomy with diverticulectomy, 19 cases that underwent an ileocecectomy, and 13 cases that underwent a right hemicolectomy. There were no statistically significant difference in complications among 3 groups (P=0.148). However, there were statistical differences among the 3 groups in the length of hospital stay (P=0.016), and the use of intravenous antibiotics (P<0.001), and the use of oral antibiotics (P=0.019).
CONCLUSION
When the preoperative diagnosis is exact, uncomplicated right colon diverticulitis can be managed by conservative treatment. On the other hand, an ileocecectomy or a right hemicolectomy is the proper treatment for complicated right colon diverticulitis. However, if uncomplicated right colon diverticulitis is diagnosed intraoperatively, conservative treatment or a diverticulectomy should be considered.

Citations

Citations to this article as recorded by

Primary epiploic appendagitis: Reconciling CT and clinical challenges
Jamel Saad, Hussein Ali Mustafa, Asem Mohamed Elsani, Fawaz Alharbi, Saad Alghamdi
Indian Journal of Gastroenterology.2014; 33(5): 420. CrossRef
Management of Right Colonic Uncomplicated Diverticulitis: Outpatient Versus Inpatient Management
Hyoung‐Chul Park, Byoung Seup Kim, Bong Hwa Lee
World Journal of Surgery.2011;[Epub] CrossRef
Clinical Characteristics of Primary Epiploic Appendagitis
Young Un Choi, Pyong Wha Choi, Yong Hwan Park, Jae Il Kim, Tae Gil Heo, Je Hoon Park, Myung Soo Lee, Chul Nam Kim, Surk Hyo Chang, Jeong Wook Seo
Journal of the Korean Society of Coloproctology.2011; 27(3): 114. CrossRef
A Case of Ascending Colon Diverticulitis with Perforation in a Child
Joon Woo Baek, Jae Young Shin, Jee Hyun Lee, So Young Jung, Ah Young Jung, Jeong Won Kim, Kon Hee Lee
Korean Journal of Pediatric Gastroenterology and Nutrition.2010; 13(2): 193. CrossRef

Diverticulitis of the Right Colon: Tips for Preoperative Diagnosis and Treatment Strategy.: Lee, In Kyu , Kim, Su Hong , Lee, Yoon Suk , Kim, Hyung Jin , Lee, Sang Kuon , Kang, Won Kyung , Ahn, Chang Hyeok , Oh, Seong Taek , Jeon, Hae Myung , Kim, Jun Gi , Kim, Eung Kook , Chang, Suk Kyun; J Korean Soc Coloproctol. 2007;23(4):223-231.; DOI: https://doi.org/10.3393/jksc.2007.23.4.223

2,542 View
31 Download
17 Citations

Abstract PDF

PURPOSE
The planned therapy of right colonic diverticulitis is very difficult because preoperative diagnosis is uncommon and the method of treatment is usually decided at the time of laparotomy. We retrospectively analyzed the clinical characteristics of right colonic diverticulitis, the clinical distinctions between preoperatively and postoperatively diagnosed patients, the recurrence rate, and the hospital stay by treatment modality.
METHODS
Among 104 patients who were treated for right colonic diverticulitis from January 1997 to May 2005, we enrolled 90 patients who had been diagnosed by the operation or a barium enema study (BE), and who had not been lost to follow-up. Patients were divided into three groups based on treatment modality: Group 1 (n=28), conservative management with intravenous antibiotics; Group 2 (n=46), aggressive resection; Group 3 (n=16), appendectomy with intravenous antibiotics.
RESULTS
Ultrasound and computed tomography (CT) detected 12 (22.6%) and 21 (87.5%) cases of right colonic diverticulitis, respectively. BE was applied to 45 patients, 28 (62.2%) of them with multiple diverticula. Right colonic diverticulitis was the preoperative diagnosis in 39 patients (43.3%). The length of hospital stay was significantly different between the groups (P<0.001): 4.9+/-3.1 days in Group 1, 7.5+/-3.7 days in Group 2, and 3.8+/-0.9 days in Group 3. Two patients (7.1%) in Group 1, 2 patients (4.3%) in Group 2, and 5 patients (31.3%) in Group 3 had recurrent diverticulitis during the follow-up period (P=0.007). The Kaplan-Meier estimated recurrence rates for Groups 1, 2, and 3 were statistically significantly different (P=0.0086).
CONCLUSIONS
To differentiate right colonic diverticulitis from appendicitis, focusing on the peculiar feature in contrast to appendicitis and appropriate utilization of CT are important. If diagnosed preoperatively, uncomplicated right colonic diverticulitis can be managed by conservative management with intravenous antibiotics. If diagnosed intraoperatively, aggressive resection is advocated as the most effective method for decreasing the recurrence rate.

Citations

Citations to this article as recorded by

Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center
Laila Jedidi, Aymen Mabrouk, Hela Ghali, Anis Ben Dhaou, Senda Ben Lahouel, Sami Daldoul, Houyem Said Latiri, Mounir Ben Moussa
World Journal of Surgery.2024; 48(6): 1509. CrossRef
Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina
René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi
Annals of Coloproctology.2023; 39(2): 123. CrossRef
Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature
Isabelle Uhe, Jeremy Meyer, Manuela Viviano, Surrennaidoo Naiken, Christian Toso, Frédéric Ris, Nicolas C. Buchs
Colorectal Disease.2021; 23(10): 2515. CrossRef
Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
Surgical Endoscopy.2020; 34(5): 2019. CrossRef
Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study
Yosuke Sasaki, Fumiya Komatsu, Naoyasu Kashima, Takahiro Sato, Ikutaka Takemoto, Sho Kijima, Tadashi Maeda, Takamasa Ishii, Taito Miyazaki, Yoshiko Honda, Nagato Shimada, Yoshihisa Urita
World Journal of Clinical Cases.2019; 7(12): 1393. CrossRef
Right-sided acute diverticulitis: A single Western center experience
Francesco Monari, Maurizio Cervellera, Basilio Pirrera, Umberto D'Errico, Samuele Vaccari, Laura Alberici, Valeria Tonini
International Journal of Surgery.2017; 44: 128. CrossRef
Diagnosis and Management of Right Colonic Diverticular Disease: A Review
Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
Cirugía Española (English Edition).2016; 94(10): 553. CrossRef
Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
Cirugía Española.2016; 94(10): 553. CrossRef
Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?
Renol M. Koshy, Abdelrahman Abusabeib, Saif Al-Mudares, Mohamed Khairat, Adriana Toro, Isidoro Di Carlo
World Journal of Emergency Surgery.2016;[Epub] CrossRef
Risk factors for recurrence of right colonic uncomplicated diverticulitis after first attack
Hyoung-Chul Park, Byung Seup Kim, Kwanseop Lee, Min Jeong Kim, Bong Hwa Lee
International Journal of Colorectal Disease.2014; 29(10): 1217. CrossRef
Surgical management of colonic diverticular disease: Discrepancy between right- and left-sided diseases
Heung-Kwon Oh
World Journal of Gastroenterology.2014; 20(29): 10115. CrossRef
Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study
Tae Jung Kim, In Kyu Lee, Jong Kyung Park, Yoon Suk Lee, Youn Si, Hun Jung, Hyung Jin Kim, Sang Chul Lee, Dae Young Cheung, Lee D. Gorden, Seung Taek Oh
Journal of the Korean Society of Coloproctology.2011; 27(4): 188. CrossRef
Management of Right Colon Diverticulitis
Jong Ik Jang, Yang Soo Lim, Jong Woo Choi, Yoon Sik Lee
Journal of the Korean Society of Coloproctology.2010; 26(1): 22. CrossRef
Treatment of Right Colonic Diverticulitis: The Role of Nonoperative Treatment
Ma Ru Kim, Bong-Hyeon Kye, Hyung Jin Kim, Hyeon-Min Cho, Seong Taek Oh, Jun-Gi Kim
Journal of the Korean Society of Coloproctology.2010; 26(6): 402. CrossRef
Right Colonic Diverticulitis
In Kyu Lee
Journal of the Korean Society of Coloproctology.2010; 26(4): 241. CrossRef
A Case of Ascending Colon Diverticulitis with Perforation in a Child
Joon Woo Baek, Jae Young Shin, Jee Hyun Lee, So Young Jung, Ah Young Jung, Jeong Won Kim, Kon Hee Lee
Korean Journal of Pediatric Gastroenterology and Nutrition.2010; 13(2): 193. CrossRef
Laparoscopic and Open Surgery for Right Colonic Diverticulitis
In Kyu Lee, Yoon Suk Lee, Sung Jip Kim, D. Lee Gorden, Dae Youn Won, Hyeung Jin Kim, Hyeun Min Cho, Hae Myung Jeon, Jun-Gi Kim, Seong Taek Oh
The American Surgeon™.2010; 76(5): 486. CrossRef

Comparison of Recovery of Bowel Motility after Laparoscopic-assisted and Open Surgery for Right Colon Cancer: A Study of Gastric Emptying by Using Sitz-marker(TM) and Changes of Intraperitoneal Temperature.: Park, Chan Wook , Choi, Gyu Seog , Jun, Soo Han; J Korean Soc Coloproctol. 2004;20(6):351-357.

1,052 View
4 Download

Abstract PDF: PURPOSE
Early recovery of gastrointestinal motility is one of the main advantages of laparoscopic intestinal surgery. However, the reasons for this advantage are still not well known. To compare recovery of bowel motility after laparoscopic-assisted and open surgery for right colon cancer, we analyzed early clinical results, including both the gastric emptying time by using a Sitz-marker(TM) and the intraperitoneal temperature.
METHODS
From January 1996 to December 1999, 80 curative right hemicolectomies, which were divided into a laparoscopic-assisted surgery group (LS) with 36 patients and an open surgery group (OS) with 44 patients, were prospectively, but not randomly, studied for recovery of bowel motility. Clinical results, such as the pain score, the time to gas passage, the time to resumption of meals the hospital stay and the gastric emptying time obtained by using a Sitz-markers(TM), were evaluated. At the beginning and the end of the operation, the intraperitoneal temperature was checked at three different points.
RESULTS
In the LS and OS groups, the first flatus passed at the 3.0 and the 3.67 postoperative day (POD) and oral intake resumed at the 3.9 and the 5.2 POD, respectively (P<0.05). The numbers of Sitz-markers(TM) remaining in the stomach after surgery were 15.0 and 18.7 at the 1st POD (P<0.0001), 6.4 and 10.8 at the 2nd POD (P>0.05), 1.7 and 4.2 at the 3rd POD (P<0.05) and 0 and 1.1 at the 4th POD (P<0.05), respectively. No difference in intraperitoneal temperature was noted.
CONCLUSIONS
We found earlier recovery of bowel function after laparoscopic surgery than after open surgery, but could not identify any relationship between bowel function and the possible parameter of intraperitoneal temperature.

The Usefulness of Colonoscopy in the Management of Right Side Colonic Diverticulitis.: Lee, Eun Kyu , Kim, Hung Dai , Son, Beong Ho , Han, Won Kon; J Korean Soc Coloproctol. 2001;17(6):283-288.

1,315 View
13 Download

Abstract PDF: PURPOSE
Most patients who finally diagnosed as the cecal and ascending colonic diverticulitis would complain pain on right low quadrant of abdomen. So many of them unfortunately would be performed emergency operation for presumed appendicitis. We are purposed to verify the usefulness of colonoscopy for the diagnosis and aimed to treat many patients with this disease conservatively.
METHODS
We reviewed retrospectively the medical records of the 46 patients who diagnosed as the cecal and ascending colonic diverticulitis under admission at general surgery department during 4 years from January, 1997 to December, 2000.
RESULTS
The mean age was 40.1 years and the male to female ratio was 1.2:1. Most common clinical manifestation was abdominal pain (46 cases) and nausea/vomiting (13 cases), fever/chill (4 cases) followed. On physical examination on abdomen, 26 patients had tenderness with rebound tenderness on right low quadrant and 18 patients showed only tenderness on right low quadrant. The mean peripheral WBC count was 10,600.9/mm2. Diagnostic tools were abdominal ultrasonography (34 cases), abdominal CT (13 cases), barium enema (8 cases) and colonoscopy (22 cases). The sensitivities of each modalities were 52.6%, 46.2%, 33.3% and 81.8% respectively. The respective mean hospital days depending on the treatment arms were as follows: 6.0 days of the conservatively treated group, 8.0 days of whom were operated as exploratory laparotomy with incidental appendectomy and 16.9 days of whom were operated as Right-hemicolectomy. 17 patients of 24 colonoscopy-done patients were recovered with conservative treatment, compared with only 7 patients of 22 colonoscopy-undone patients (P=0.0005). 2 cases of the conservatively managed groups were operated later due to recurrences (mean follow up periods=20 months). 2 operated patients had complications of postoperative ileus.
CONCLUSIONS
Based on our study, the indications of colonoscopy are that in whom impressed clinically as acute appendicitis, on physical examination there be obvious tenderness on right low quadrant but obscure rebound tenderness, on peripheral blood smear the WBC counts range from normal to mild increased (<15,000/mm2), and on ultrasonography, appendix couldn't be detected or colonic wall show thickening. In patients who selected fit for indications, colonoscopy is safe and highly sensitive. We would manage these patients more conservatively, and may reduce their hospital stay.

Surgical Treatment of Right Colon Diverticulitis.: Lee, Do Sang , Lee, Chul Soo , Sung, Gi Young , Song, Moo Hyung , Kim, Wook , Park, Il Young , Won, Jong Man; J Korean Soc Coloproctol. 2000;16(5):302-308.

1,373 View
12 Download

Abstract PDF: PURPOSE
Diverticular disease of the cecum and ascending colon is a relatively uncommon disease and there are some difficulties in the accurate preoperative diagnosis and the proper surgical treatment. This study is aimed to determine what is the proper procedure during the emergency operation of right colon diverticulitis.
METHODS
This study is a retrospective clinical analysis of 86 cases of the right colon diverticulitis from January 1992 to December 1999.
RESULTS
1) The incidence of right colon diverticulitis (RCD) was 2.1% of that of appendicitis and the RCD to sigmoid colon diverticulitis ratio was 9.6:1.2) The highest incidence was noted at the fourth decades and average age was 37 years. Male to female ratio was 1.9:1. 3) Most patients (73 cases, 85%) had right lower quadrant abdominal pain. 4) The duration of symptom was less than 3 days in 54 cases (63%). 5) The preoperative confirmation by radiologic work-up was not decisive, but barium enema might be more accurate than other studies and CT was more accurate method than ultrasound. 6) The correct preoperative diagnosis was made only in 13 cases (15%) and the remaining misdiagnoses were appendicitis with or without complications in 72 cases (83%). 7) Operative procedures varied markedly according to multiplicity, extent of inflammation and complications; diverticulectomy and appendectomy in 48 cases (56%), ileocecectomy in 15 cases (17%) and right hemicolectomy in 11 cases (13%). 8) The most commom postoperative complication was wound infection. 9) Among the 30 cases who took diverticulectomy or diverticulectomy and appendectomy, remained diverticulums were found in 14 cases (47%), especially 11 cases (37%) on the right colon. And so multiplicity of right colon reached about 37%.
CONCLUSIONS
The authors suggest that one should suspect RCD in fourth decade patients with right lower quadrant pain for more than 3 days with unusual clinical findings. Barium enema can be used because of the high accuracy rate but CT is a safe tool in complicated or urgent situation. The operative modalities should be selected on the extent of the disease and it is sufficient to treat a single diverticulitis with diverticulectomy or diverticulectomy and appendectomy but right hemicolectomy should be recommanded in the suspicious multiplicity or malignancy.

Clinical Analysis of Right Colonic Diverticulitis That was Operated under the Impression of Acute Appendicitis.: Cho, Hyeoun Jun , Cho, Seung Yeon , Oh, Jae Hwan; J Korean Soc Coloproctol. 2000;16(1):18-24.

1,446 View
36 Download

Abstract PDF: PURPOSE
Because there are no significant differences of the clinical findings between the appendicitis and cecal diverticulitis, it is very difficult to make a correct diagnosis preoperatively and to choose a appropriate management intraoperatively. The purpose of this study is to investigate the clinical charateristics of right diveticulitis and to evaluate the appropriateness of surgical management.
METHODS
We reviewed 45 cases of right colonic diverticulitis which underwent emergency operation under the impression of acute appendicitis during 10 years from January 1988 to December 1997.
RESULTS
Of them, 38 cases were treated by diverticulectomy with appendectomy (Group I), and 7 cases were treated by resection (ileocecal resection or right hemicolectomy) (Group II). The male to female ratio was 4:1, and the mean age was 38.2 years. In Group I, all cases had a solitary inflamed cecal diverticulum. In group II, two cases had a solitary cecal diverticulitis, whereas five cases had multiple ones. Postoperative complications were found in 14 cases, but all of them were not significant. Postoperative Barium enema was performed in 22 cases of Group I, in two cases of Group II. In Group I, 8 cases had a residual diverticulum at postoperative Barium enema. In Group II, no residual diverticulum was shown. Follow-up study by Telephone was done at 16 cases, there were no symptomatic recurrences.
CONCLUSIONS
In conclusion, when right colonic diverticulitis is found at the time of operation, surgical management is a safe treatment with low morbidity and low recurrence rate. Diverticulectomy with appendectomy is a safe surgical procedure for the uncomplicated diverticulitis. If diverticulitis is complicating, multiple or undistinguishable with malignancy, resection (ileocecal resection, right hemicolectomy) should be considered as a primary surgical treatment. Postoperative colon study is helpful, due to high incidence of residual diverticulum.

Case Report

A Case of Synchronous Triple Primary Adenocarcinomas Occurring at the Duodenum, Right Colon and Sigmoid Colon.: Kim, Young Wan , Kim, Nam Kyu , Lee, Jae Kil , Kim, Won ho , Kim, Ju Hang , Min, Jin Sik; J Korean Soc Coloproctol. 1999;15(4):351-356.

1,080 View
20 Download

Abstract PDF: It is rare to find three separate primary cancers in one individual. But, multiple primary cancers have been increasing because of improved methods of diagnosis and treatment and greater longevity of the population. We experienced a 52-year old male patient with synchronous triple primary adenocarcinomas occurring at the duodenum, right colon and sigmoid colon, who complained of abdominal pain and hematochezia for 2 months. The patient underwent pancreaticoduodenectomy, right hemicolectomy, and anterior resection, and was recovered uneventfully. After surgery, postoperative adjuvant chemotherapy (5-FU and Leucovorin) is currently being administered.

First
Prev
Page of 1
Next
Last

Search