Clinical Analysis of Right Colon Diverticulitis

ABSTRACT

PURPOSE: There are several ways of treating for right colon diverticulitis, based on its complications or location. The kind of operation emplolyed with cecal diverticulitis is still controversial, due to its similar symptoms to those of acute appendicitis, and is usually diagnosed during an appendectomy. This study is an analysis of 65 patients, which we experienced over the past 10 year, with right colon diverticulitis. METHODS: The hospital records of 65 patients with right colon diverticulitis, between January 1991 and January 2001, from the Catholic University School of Medicine, St. Paul's Hospital department of surgery were retrospectively reviewed. We analyzed the clinical data and outcomes, according to three different types of operation. RESULTS: The male to female ratio of the patients was 1.41, with a mean age of 36.8, ranging from 14 to 81 years. The most common manifestation was abdominal pain and tenderness (100%). Of the 65 cases, 53 underwent a diverticulectomy and an appendectomy, 5 a right hemicolectomy or an ileocecetomy and 7 an appendectomy only. The most common location of the diverticulum was cecum (62 cases), and the majority were single diverticulum (62 cases). There were complications in 4 cases (6.1%) following the operation, but their symptoms were mild. The complication rates in the diverticulectomy and appendectomy and appendectomy only groups were 5.6 and 14.2% respectively. However, there were no significant differences in the complication rates among 3 groups. There was no recurrence in the group with a right hemicolectomy or ileocecectomy, or in the group with a diverticulectomy and an appendectomy. The recurrences in the appendectomy only group were significantly higher than the groups, with 3 (42.8%) out of 7 cases (P=0.001). CONCLUSION: We suggest that an operation may be the primary safe treatment of right colon diverticulitis and that a diverticulectomy and an appendectomy may be reasonable operative methods that decrease the recurrence and morbidity of right colon diverticulitis.