Acute Cecal Diverticulitis

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Abstract
An evaluation of acute cecal diverticulitis with right lower quadrant pain or melena was carried out in a study of 25 patients. The diagnosis was difficult even in patients with prior appendectomy. The typical case was a middle-aged man, ill for about 60 hours with inflammatory disease of the right lower abdomen. Four patients presented with painless melena and 5 with a mass. Preoperative examination of the colon by x-ray was performed unless acute appendicitis was suspected. Four of 9 nonacute cases were correctly diagnosed. Cecal diverticulitis usually causes a firm, indurated, red to purple mass near the ileocecal valve and should be differentiated from carcinoma. Local excision and appendectomy are recommended when possible. Right hemicolectomy should be avoided with unprepared bowel.

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