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[Right-sided diverticulitis: new diagnostic and therapeutic aspects]
T Eggimann1, C Küng, C Klaiber
1Chirurgische Klinik, Spital Aarberg.
Schweizerische Medizinische Wochenschrift
|February 12, 1998
Summary
Ascending colon diverticulitis, rare in the West, is often misdiagnosed. Conservative antibiotic therapy is effective for uncomplicated cases, avoiding surgery and ensuring pain-free recovery.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Abdominal Imaging
Background:
- Ascending colon diverticulitis is uncommon in Western populations.
- It is frequently misdiagnosed as appendicitis due to right lower quadrant abdominal pain.
- Rarity leads to it being overlooked in differential diagnoses.
Observation:
- A study of five patients with right-sided diverticulitis highlights diagnostic and therapeutic approaches.
- Computed tomography (CT) scans and laparoscopy proved valuable in diagnosis, identifying peridiverticular changes.
- Conservative management with antibiotics alone was successful in three cases, while others required surgical intervention.
Findings:
- Antibiotic therapy alone achieved successful outcomes in a majority of uncomplicated ascending colon diverticulitis cases.
- Surgical options included right hemicolectomy and laparoscopic diverticulectomy for more complex presentations.
- Average hospital stay was twelve days with no complications, and patients remained symptom-free during follow-up.
Implications:
- CT scans and laparoscopy are crucial for accurate diagnosis of ascending colon diverticulitis.
- Conservative management with antibiotics should be considered for initial, uncomplicated episodes, challenging traditional surgical approaches.
- Early and accurate diagnosis can lead to effective treatment and improved patient outcomes.