Cecal Diverticulitis: an Unusual Cause of Acuteright Iliac Fossa Pain—a Case Report
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Date
2024-07
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FORUM: Fraternity of national Research & pUblication Society of Medical sciences
Abstract
INTRODUCTION: The cecal diverticulum is a rare disease with reported incidence of 0.04% to 2.1% (1–3). 85% of diverticulum occurs more commonly in the descending and sigmoid colon rather than in cecum [1]Diverticulae of the colon are mucosal herniations in the colon wall muscle layer through (relatively weaker) points of entry of blood vessels through the colonic wall13 and are more commonly found in the sigmoid colon and descending colon. Caecal diverticulitis is a rare clinical problem, its signs and symptoms are very similar to those of appendicitis. OBJECTIVE - Here we present a case of caecal diverticulitis which was diagnosed with the help of various radiological investigations and was managed conservatively with a positive outcome. We were able to avoid operative intervention owing to the specificity of the ultrasonography and computerized tomography in ruling out other conditions that preclude conservative management.The management of diverticulitis of cecum is varied and controversial due to lack of randomized trials comparing conservative and aggressive surgical treatment methods. METHOD - A 70 year-old diabetic and hypertensive male patient presented to the hospital’s emergency department with a 72-hour history of a severe right, lower abdominal quadrant pain with accompanying nausea and vomiting. Physical examination revealed clinical signs of acute abdomen with local rebound tenderness and guarding in the right iliac fossa. An ill-defined lump of 3 × 4 cm was palpated in the RIF extending to the hypogastrium.So we diagnosed the patient with available radiological and othe modalities so we can take the decision for operative or conservative management RESULTS - Caecal diverticulitis is a rare clinical problem in the Western world, more commonly seen in the descending and sigmoid colon [2]. We were able to avoid operative intervention owing to the specificity of the ultrasonography and computerized tomography in ruling out other conditions that preclude conservative management.Solitary diverticulitis of the cecum, even if it is a rare entity, should be taken into consideration during the differential diagnosis of patients complaining of right iliac fossa pain. CONCLUSION - The use of radiological investigations such as abdominal USG and CT scan for the evaluation of the right abdominal pain is very helpful for diagnostic accuracy and avoiding unexpected findings in the operating theatre. A careful preoperative assessment to diagnose the pathology and to diminish the possibility of surgical intervention is necessary as the as the mainstay of therapy for rightcolonic diverticulitis is medical rather than operative management
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Keywords
CECAL ,DIVERTICULITIS, RIGHT, ILIAC, FOSSA, PAIN
Citation
Sharma Jaykumar V., Aswani Varsha, Bhadreshwara Kamlesh A., Patel Shaishav V., Kotwal Dipen K.. Cecal Diverticulitis: an Unusual Cause of Acuteright Iliac Fossa Pain—a Case Report. Indian Journal of Applied Basic Medical Sciences. 2024 Jul; 26B(2): 1-9