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A Journal on Surgery

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Chirurgia 2000 October-December;13(5-6):297-8

language: Italian

Perforated diverticulum of the cecum

Interlandi A., Busacca G., Interlandi D.

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A case of perforation of a diverticulum of the cecum is reported. Its diagnosis is not easy, almost never preoperative and, in most cases, it is often made during a laparatomy, where the presence of a pathologist is required. From the anatomic and clinical point of view, diverticula can be grouped into ''true'' and ''false'', ''congenital'' and ''acquired''; they can also be ''single'' or ''multiple''. Mostly, diverticula can be found in the left colon, especially in the sigmoid (90% of cases). Localisation in the right colon is very rare: in literature it accounts for 1-5% of all the patients suffering from diverticula, i.e. 0.9%-1.7% of the normal population. Diverticula are often multiple on the left and single on the right. The diagnosis is often radiological (double contrast barium enema). In the case presented the pathology was located on the right, but with multiple diverticula. In the preoperative phase no certain diagnosis was made; appendicitis was excluded as the patient had already had an appendectomy and a laparotomy was carried out because a perforated neoplasia was suspected. Therapy for a complex diverticulitis is the segmentary resection of the right colon and, if in doubt of neoplasia, when the support of morbid anatomy is not available, conventional right hemicolectomy is suggested.

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