Exploration of clinical diagnosis and treatment for acute typhlitis / 临床外科杂志

ABSTRACT

Objective To improve the understanding of acute typhlitis.Methods all 5 cases of acute typhlitis from February 1999 to August 2001 were reviewed,5 cases were preoperatively misdiagnosed as acute appendicitis and subsequently performed emergency operations.Moreover,misdiagnosis was made intraoperatively as tumor in 2 cases,Crohn disease in 2 cases and diverticulitis in 1 case.Right hemicolectomy was performed in 4 cases;resection of necrotic mass and ileostomy was performed in 1 case.Results The pathologic change was acute non-specific inflammation of cecum in 5 cases.All cases recovered uneventfully.They are in good condition during the follow-up range 4 to 30 months.Conclusions The clinical manifestation of typhlitis was nonspecific.It was extremely difficult to diagnose preoperatively.Inflammatory mass of external lateral wall of cecum was characteristic finding of typhlitis during laparatomy.It is difficult to differentiate from tumor or Crohn disease at intraoperation.Right hemicolectomy was satisfactorily recommended.