Most patients with diverticulitis of the cecum and ascending colon present with acute pain in the abdomen, nearly indistinguishable from that of appendicitis. Before the operation, the correct diagnosis may be difficult to predict with certainty.
Therefore the surgeon must be aware of the possibility of diverticulitis of the cecum and ascending colon in the operating room and choose the appropriate treatment once be makes the diagnosis. During the past 8 years, a total of 54 cases of
cases
of
diverticula of the cecum and ascending colon have been treated at this hospital, including 44 cases which were treated surgically and 10 cases which were treated conservatively. The average age of the patients was 34.3 years. The male to female
ratio
was 2.6:1. Appendicitis accounted for 59 per cent of the preoperative diagnosis. The mean duration of illness prior to seeking medical attention was 3.5 days. Nausea/vomiting and anorexia were found with low incidence of 16.7 per cent and 11.1
per
cent,
respectively, compared with those of appendicitis. Correct preoperative diagnosis was made in 19 patients(35%). In the 44 cases which were treated surgically, 18 Diverticulectomies with appendectomies were performed, 16 cecectomies, and 10 right
hemicolectomies. Postoperative morbidity and mortality was not found except 2 cases of wound infection. The authors conclude 1) Barium contrast study in patients who are suspected appendicitis with relatively long history of illness, atypical
abdominal
tender point, repeated attacks of symptoms, and recurrent picture after prior appendectomy will be valuable to preoperative diagnosis. 2) resection of the diverticular lesion and intraoperative frozen section, when possible, to eliminate the
possible,
to eliminate the possibe risk of overlooking malignant lesion and the risk of recurrent diverticulitis would be better.
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