Perforation of Cecal Diverticulum after Appendectomy

Area of Science:

• Gastroenterology and Surgical Case Reports
• Abdominal Surgery
• Gastrointestinal Pathology

Background:

• Solitary cecal diverticulum, first described in 1912, is rare but more prevalent in Asian populations.
• While often asymptomatic, 10-20% of cecal diverticula lead to symptomatic complications, primarily diverticulitis, but also perforation, hemorrhage, and obstruction.

Observation:

• Cecal diverticulum is frequently diagnosed perioperatively, often mistaken for acute appendicitis.
• Preoperative diagnosis using imaging like ultrasound (USG), CT, and MRI is uncommon.
• This case report details a 54-year-old male with cecal diverticulum perforation in the early postoperative period after an appendectomy.

Findings:

• The patient presented with abdominal distension, tenderness, and rebound, indicative of peritonitis.
• Laparotomy revealed cecal diverticulum perforation, necessitating diverticulectomy using a linear stapler.
• Histopathological examination confirmed a co-occurrence of acute appendicitis and cecal diverticulitis.

Implications:

• Concurrent cecal diverticulitis should be considered in appendectomy cases, with simultaneous diverticulectomy as the recommended surgical approach.
• This case underscores the importance of recognizing cecal diverticulum complications, especially post-appendectomy.
• Accurate preoperative diagnosis and surgical management are crucial for preventing severe outcomes associated with cecal diverticulum complications.