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KMID : 0365719950110010100
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Journal of Pusan Surgical Society
1995 Volume.11 No. 1 p.100 ~ p.106
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Clinical Evaluation of Colonic Diverticular disease
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Abstract
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Colonic diverticular disease is relatively uncommon in Orient, In Oriental population diverticular disease is located predominantly to the right colon in contrast to the left sided domination observed in Western populations. We experienced 29
cases
of
diverticulosis of the right colon from September 1989 to September 1994 at the department of surgery, Pusan City Medical Center. Of 29 cases, 17 cases were male and 12 cases were female and 24 cases were over 30 years of age. The most common
preoperative diagnosis and symptom were acute appendicitis(16 cases) and right lower quadrant pain(62%). The locations of the diverticulums were cecum only (22 cases), ascending colon(3 cases) and cecum and ascending colon(3 cases), entire
colon(1
cases). The numbers of diverticulum were multiple in 4 cases and single in 24 cases. The surgical procedures of the right colonic diverticulosis were diverticulectomy with appendectomy(18 cases), ileocecetomy(6 cases), right hemicolectomy(4
cases)
and
appendectomy(1 cases). The pathologic diagnosis were diverticulitis(20 cases) and peridiverticular abscess(8 cases). The most common postoperative complication was wound infection(4 cases) and one patient was died due to acute myocardial
infarction. It
is desirable that, if possible, preoperative barium study is recommended at the case of mimicking appendicitis, because right colonic diverticulosis is difficult to differentiated from acute appendicitis based upon the clinical findings. If right
colonic diverticulosis is found incidentally at the time of laparotomy for appendicitis, if possible, diverticulectomy or segmental resection of the intestine appears to be appropriate surgical treatment.
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