Management of Cecal Diverticulitis

Sung, Jong Je; Song, Dan; Hong, Gaun Yue; Park, Nae Kyeong

Abstract

PURPOSE: Diverticular disease of the cecum and ascending colon is a relatively uncommon disease, and is often difficult to diagnose. The purpose of this study was to investigate the clinical features of patients who underwent surgical treatment for cecal diverticulitis.
METHODS
A retrospective review was conducted between January 1998 and December 2002 of 44 patients treated at the Department of Surgery, Soonchunghyang Gumi Hospital.
RESULTS
All patients presented with right lower quadrant pain and tenderness. Preoperatively, 34 patients were diagnosed with acute appendicitis. The surgical procedures for cecal diverticulitis were an appendectomy only (5 cases), a diverticulectomy with appendectomy (31 cases), and a right hemicolectomy (8 cases). Postoperative complications were found in 17 cases: wound infection (13 cases), and partial intestinal obstruction (2 cases).
CONCLUSIONS
When cecal diverticulitis is found at the time of an operation, surgical management is a safe treatment with low morbidity and a low recurrence rate. A diverticulectomy with appendectomy is a safe and effective procedure for the treatment of cecal diverticulitis if there is no evidence of free perforation or abscess formation. If the diverticulitis is complicated, undistinguishable from a malignancy, a resection (ileocecal resection, right hemicolectomy) should be considered for the surgical treatment.