Olgu Sunumu
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A Rare Entity: Coexistence of Acute Appendicitis and Cecal Diverticulitis

Yıl 2024, Cilt: 4 Sayı: 1, 30 - 33, 22.04.2024
https://doi.org/10.58961/hmj.1419585

Öz

In this case report, we wanted to present the diagnostic and treatment process of a patient who was diagnosed with acute appendicitis in the preoperative period, was taken to surgery, and was diagnosed with cecum diverticulitis in the perioperative period. A 36-year-old female patient was admitted to our emergency department with complaints of abdominal pain, nausea, and loss of appetite for 3 days. Abdominal pain started in the lower right abdomen and gradually increased in severity as the day passed. On physical examination, there was defense and rebound localized to the lower right quadrant of the abdomen. In the laboratory, the white blood cell count was within normal limits (7.4 10*9 L-1) and the c-reactive protein (CRP) level was 79 mg L-1 (0-5 mg L-1). On abdominal ultrasonography, the diameter of the appendix vermiformis was measured as 8.5 mm, and it was observed that there was increased echogenicity in the fatty tissue around the appendix vermiformis. The patient was taken to emergency surgery. During exploration, the appendix was observed to be oedematous. Additionally, diverticulitis was observed in the anterior wall of the cecum, close to the ileocecal area. Simultaneous appendectomy and diverticulectomy were performed. The patient was discharged without complications on the 4th postoperative day.

Kaynakça

  • Potier F. Diverticulite and appendicite. Bull Mem Soc Anat Paris. 1912;37:29-31.
  • Kyziridis DS, Parpoudi SN, Antoniou ND et al. Cecal diverticulitis is a challenging diagnosis: a report of 3 cases. Am J Case Rep. 2015;16:206-210.
  • Sardi A, Gokli A, Singer JA. Diverticular disease of the cecum and ascending colon. A review of 881 cases. Am Surg. 1987;53:41-5.
  • Uhe I, Meyer J, Viviano M et al. Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature. Colorectal Dis. 2021;23(10):2515-2526.
  • Alimoglu O, Sahin M, Cevikbas U, Eryilmaz R. Solitary cecal diverticulitis: report of a case. Eur Surg. 2003;35:344-345. 
  • Kalcan S, Başak F, Hasbahçeci M et al. Intraoperative diagnosis of cecal diverticulitis during surgery for acute appendicitis: Case series. Turkish Journal of Surgery. 2016;32(1):54-57.
  • Hot S, Eğin S, Gökçek B, et al. Solitary caecum diverticulitis mimicking acute appendicitis. Ulus Travma Acil Cerrahi Dergisi. 2015;21(6):520-23.
  • Cristaudo A, Pillay P, Naidu S. Caecal diverticulitis: Presentation and management. Ann Med Surg (Lond). 2015(Mar);4(1):72-75.
  • Turner GA, O’Grady MJ, Purcell RV et al. The epidemiology and etiology of right-sided colonic diverticulosis: A Review. Ann Coloproctol. 2021 Aug;37(4):196-203.
  • Epifani AG, Cassini D, Cirocchi R et al. Right sided diverticulitis in western countries: A review. World J Gastrointest Surg. 2021 Dec 27;13(12):1721-1735.
  • Tsetse C, Chaudhry SR, Jabi F, et al. Perforated cecal diverticulitis with CT diagnosis and medical management. Radiol Case Rep. 2018 Oct 4;14(1):30-35.
  • Gonullu E, Yigit M, Mantoglu B et al. Management of solitary cecum diverticulitis – Single-Center Experience. Pol Przegl Chir. 2021 Mar 16;93(4):15-20.
  • Chen Z, Zhang B, Wu D et al. Characteristics of predominantly right-sided colonic diverticulitis without need for colectomy. BMC Surg. 2020 Sep 14;20(1):202.
  • Pavlidis ET, Pavlidis TE. Current aspects on the management of perforated acute diverticulitis: A narrative review. Cureus. 2022 Aug 26;14(8):e28446.

Nadir Bir Durum: Akut Apandisit ve Çekal Divertikülitin Birlikteliği

Yıl 2024, Cilt: 4 Sayı: 1, 30 - 33, 22.04.2024
https://doi.org/10.58961/hmj.1419585

Öz

Bu olgu sunumunda ameliyat öncesi dönemde akut apandisit tanısı konularak ameliyata alınan ve perioperatif dönemde çekum divertiküliti tanısı konulan bir hastanın tanı ve tedavi sürecini sunmak istedik. 36 yaşında kadın hasta, 3 gündür devam eden karın ağrısı, bulantı, iştahsızlık şikayetiyle acil servisimize başvurdu. Karın ağrısı sağ alt karın bölgesinde başladı ve gün geçtikçe şiddeti giderek arttı. Fizik muayenesinde batın sağ alt kadranda lokalize defans ve rebound mevcuttu. Laboratuvarda beyaz küre sayısı normal sınırlarda (7,4 10*9 L-1), C-reaktif protein (CRP) düzeyi 79 mg L-1 (0-5 mg L-1) idi. Batın ultrasonografisinde apendiks vermiformis çapı 8,5 mm olarak ölçüldü ve apendiks vermiformis çevresindeki yağ dokusunda ekojenitenin arttığı gözlendi. Hasta acil ameliyata alındı. Eksplorasyon sırasında apendiksin ödemli olduğu görüldü. Ayrıca çekum ön duvarında ileoçekal bölgeye yakın divertikülit gözlendi. Eş zamanlı apendektomi ve divertikülektomi yapıldı. Hasta ameliyat sonrası 4. günde komplikasyonsuz olarak taburcu edildi.

Kaynakça

  • Potier F. Diverticulite and appendicite. Bull Mem Soc Anat Paris. 1912;37:29-31.
  • Kyziridis DS, Parpoudi SN, Antoniou ND et al. Cecal diverticulitis is a challenging diagnosis: a report of 3 cases. Am J Case Rep. 2015;16:206-210.
  • Sardi A, Gokli A, Singer JA. Diverticular disease of the cecum and ascending colon. A review of 881 cases. Am Surg. 1987;53:41-5.
  • Uhe I, Meyer J, Viviano M et al. Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature. Colorectal Dis. 2021;23(10):2515-2526.
  • Alimoglu O, Sahin M, Cevikbas U, Eryilmaz R. Solitary cecal diverticulitis: report of a case. Eur Surg. 2003;35:344-345. 
  • Kalcan S, Başak F, Hasbahçeci M et al. Intraoperative diagnosis of cecal diverticulitis during surgery for acute appendicitis: Case series. Turkish Journal of Surgery. 2016;32(1):54-57.
  • Hot S, Eğin S, Gökçek B, et al. Solitary caecum diverticulitis mimicking acute appendicitis. Ulus Travma Acil Cerrahi Dergisi. 2015;21(6):520-23.
  • Cristaudo A, Pillay P, Naidu S. Caecal diverticulitis: Presentation and management. Ann Med Surg (Lond). 2015(Mar);4(1):72-75.
  • Turner GA, O’Grady MJ, Purcell RV et al. The epidemiology and etiology of right-sided colonic diverticulosis: A Review. Ann Coloproctol. 2021 Aug;37(4):196-203.
  • Epifani AG, Cassini D, Cirocchi R et al. Right sided diverticulitis in western countries: A review. World J Gastrointest Surg. 2021 Dec 27;13(12):1721-1735.
  • Tsetse C, Chaudhry SR, Jabi F, et al. Perforated cecal diverticulitis with CT diagnosis and medical management. Radiol Case Rep. 2018 Oct 4;14(1):30-35.
  • Gonullu E, Yigit M, Mantoglu B et al. Management of solitary cecum diverticulitis – Single-Center Experience. Pol Przegl Chir. 2021 Mar 16;93(4):15-20.
  • Chen Z, Zhang B, Wu D et al. Characteristics of predominantly right-sided colonic diverticulitis without need for colectomy. BMC Surg. 2020 Sep 14;20(1):202.
  • Pavlidis ET, Pavlidis TE. Current aspects on the management of perforated acute diverticulitis: A narrative review. Cureus. 2022 Aug 26;14(8):e28446.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi (Diğer)
Bölüm Olgu Sunumu/Olgu Serisi
Yazarlar

Harun Bayram 0000-0002-4845-1578

Tolga Kalaycı 0000-0002-6977-1757

Yayımlanma Tarihi 22 Nisan 2024
Gönderilme Tarihi 14 Ocak 2024
Kabul Tarihi 13 Şubat 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 4 Sayı: 1

Kaynak Göster

Vancouver Bayram H, Kalaycı T. A Rare Entity: Coexistence of Acute Appendicitis and Cecal Diverticulitis. HTD / HMJ. 2024;4(1):30-3.

e-ISSN: 2791-9935