[Diagnosis and surgical therapy of right-sided colonic diverticulitis]

Diverticulosis of the colon is common in the descending and sigmoid part; the right colon is rarely involved. Inflammation of perforation of a cecal diverticulum is an uncommon condition that mimics acute appendicitis. The correct diagnosis is mostly made after operative exploration. Four cases were surgically treated between 1994 and 1995. Because of the severe inflammation, ileocecal resection or right hemicolectomy was necessary; in one case we performed a local excision. After removal of the inflamed mass the postoperative healing was uncomplicated. A malignancy could be histologically excluded in all cases. As in sigmoid diverticulitis, early resection seems to be a safe operative therapy. Laparoscopy can show the correct diagnosis before the laparotomy is carried out. Preoperative diagnostic measures, differential diagnosis and possible surgical procedures are discussed.