Right-sided diverticular disease of the colon: a morphological analysis of 16 cases

Right-sided diverticular disease is uncommon and represents a heterogeneous group of cases with varying clinical presentation often confused with other disorders. Based on number, size, distribution and histological appearance of the diverticula, four distinct groups were identified, each with a distinct clinical presentation. Six patients had solitary false diverticula mimicking acute appendicitis and at operation were found to have inflamed caecal masses. Five patients had diverticula formed on the basis of defects in the muscularis propria. The mean age of these patients was 30 years older than the previous group and all of them presented with rectal haemorrhage, often confused with angiodysplasia clinically. At laparotomy the external appearance of the bowel was unremarkable. Three patients had diverticular disease similar to that seen in the left side of colon. Two patients had true congenital caecal diverticula confirming that the minority of caecal diverticula conforms to this group.