The diagnostic and therapeutic value of endoscopic irrigation for cecal suppurative diverticulitis: A case report

Cecal diverticulitis closely mimics acute appendicitis in clinical presentation, leading to frequent misdiagnosis. Traditional mistaken appendectomy is not only ineffective but may also delay proper treatment, risking serious complications such as perforation. Abdominal computed tomography plays a key role in differential diagnosis. This report explores the value of endoscopic irrigation as a novel diagnostic and therapeutic approach.

A patient presented with symptoms strongly suggestive of acute appendicitis, prompting further diagnostic workup to rule out alternative causes.

Preoperative computed tomography suggested suppurative cecal diverticulitis, which was subsequently confirmed during colonoscopy.

Targeted endoscopic irrigation and drainage were performed directly into the confined diverticular abscess cavity, with real-time visualization allowing extraction of impacted fecaliths and purulent debris.

Following endoscopic irrigation, the patient's symptoms resolved rapidly, resulting in significant improvement and discharge. At 4- and 6-month follow-ups, there was no recurrence of diverticulitis or related complications.

For carefully selected patients, endoscopic irrigation demonstrates dual diagnostic and therapeutic value in suppurative cecal diverticulitis. This minimally invasive approach effectively avoids unnecessary surgery, alleviates symptoms, and shows promising short- and mid-term outcomes. Further studies are needed to validate its broader applicability, and patient selection remains critical.