Clinical Difference between Acute Appendicitis and Acute Right-Sided Colonic Diverticulitis

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) present with similar clinical symptoms.
• Differentiation is critical as treatment strategies vary significantly between surgical and conservative management.

Purpose of the Study:

• To identify distinct clinical predictors differentiating AA from ARCD.
• To aid in accurate diagnosis and guide treatment decisions for these similar-presenting conditions.

Main Methods:

• A single-center retrospective study analyzed adult patients diagnosed with uncomplicated AA or ARCD via computed tomography.
• Clinical data, including medical history, symptoms, signs, and laboratory findings, were compared between groups.
• Logistic regression analysis was employed to identify independent predictors for each condition.

Main Results:

• The study included 212 patients with AA and 56 with ARCD.
• Logistic regression identified a history of diverticulitis as a strong predictor of ARCD (OR: 102.679).
• Predictors for AA included ketonuria (OR: 2.907), anorexia (OR: 21.544), and neutrophilia (OR: 3.406).

Conclusions:

• Anorexia, ketonuria, and neutrophilia are significant clinical predictors for acute appendicitis.
• A prior history of diverticulitis is a key indicator for acute right-sided colonic diverticulitis.
• These findings can improve diagnostic accuracy and inform treatment strategies for patients presenting with right lower quadrant abdominal pain.