Cecal diverticulitis or appendicitis: when should I suspect? A case report

The objective of this article was to report a case of cecal diverticulitis and point out the differential diagnosis of acute appendicitis. The clinical manifestations of these pathological conditions are similar, and the accurate diagnosis of cecal diverticulitis before the surgery is difficult. Therefore, most diagnoses are made during the surgery. Moreover, cecal diverticulum is uncommon in western countries, but it is prevalent in Asian people and their descendants. We report a case of a 55-year-old female patient, whose imaging exams (ultrasonography and computed tomography) and blood tests were not enough to diagnose the affection, requiring laparotomy and pathological exams for the final diagnosis. Some studies suggesting the best practice in case of diverticulum of the cecum were revised, as the diagnosis usually occurs during the surgery. (AU)

O objetivo deste trabalho foi relatar um caso de diverticulite no ceco e chamar a atenção para o diagnóstico diferencial com apendicite aguda. As manifestações clínicas das duas afecções são semelhantes, dificultando o diagnóstico exato de diverticulite cecal, além de ser incomum, em nosso meio, o aparecimento de divertículo em cólon direito, sendo essa entidade mais comum em asiáticos e em seus descendentes. Relata-se atendimento a uma paciente de 55 anos, cujos exames de imagem (ultrassonografia e tomografia computadorizada) e de sangue não foram suficientes para o diagnóstico. Houve necessidade de realizar-se laparotomia exploradora e exames anatomopatológicos para a confirmação. Também foram revisados alguns trabalhos que sugerem qual a melhor conduta a ser tomada quando se encontra divertículo cecal no perioperatório, já que, na maioria das vezes, o diagnóstico é feito neste momento. (AU)

Orocecal transit time in patients with celiac disease from North India: a case control study.

AIM: The mechanisms responsible for bowel disturbances in celiac disease are still unknown. Small bowel motor abnormalities may be involved in this pathological condition; however, there is no study addressing small bowel transit in patients of celiac disease from Northern India. METHOD: The mouth-to-cecum transit time was studied in 80 celiac patients and 80 age and sex matched apparently healthy controls. RESULTS: Orocecal transit time in celiac patients was significantly delayed being 180+/-10.6 minutes (Mean+/-SE) as compared to 105+/-12.4 minutes in apparently healthy controls. CONCLUSION: This prolonged orocecal transit time could be due to impaired small bowel function (deranged motility) in patients with celiac disease.

Caecal infarction: a rare complication of arteriography

We report an unusual case of a 44 year old woman who developed caecal infarction following a routine percutaneous transfemoral arteriography performed for worsening intermittent claudication

La vulnerabilidad del cecoascendente ante episodios de descompensación hemodinámica / The vulnerability of the cecoascendent colon in haemodinamic failure

Se presentan 7 pacientes, tratados en nuestro Servicio, con necrosis isquémica perforativa de cecoascendente, asociada con patologías extracolónicas como fiebre reumática, insuficiencia cardíaca, diabetes, insuficiencia renal crónica y colagenopatías. Se destaca el ciego como área de riesgo en las hipotensiones severas de origen funcional y farmacológico. Se mencionan hipótesis de las causas fisiopatológicas de esta rara entidad. Se analiza la conducta quirúrgica de elección.