Difference in Clinical Features between Appendicitis and Right-Sided Colonic Diverticulitis on Initial Diagnosis
Journal of the Korean Society of Coloproctology
;
: 201-206, 2005.
Artículo
en Coreano
| WPRIM
| ID: wpr-120213
ABSTRACT
PURPOSE:
Most patients who are finally diagnosed as having cecal and right-sided colonic diverticulitis complain of pain in the right lower quadrant of the abdomen, many of them unfortunately undergo an emergency operation for presumed appendicitis. Our purpose was to differentiate the diagnosis of right-sided colonic diverticulitis from appendicitis in an emergency setting.METHODS:
We retrospectively reviewed the medical records of 450 patients between January 1997 and July 2003. Among them, 92 patients who had been diagnosed as having right-sided colonic diverticulitis were classified as Group I. In the remaining 358 patients with appendicitis, 268 patients with simple appendicitis were classified as Group II and 90 patients with perforated appendicitis were classified as Group III.RESULTS:
The sex ratios were similar among 3 groups. The mean age of Group I (36.5+/-10.1 years) was significantly different from that of Group II (30.7+/-14.8 years, P=0.002), but not from that of Group III (38.7+/-20.9). Incidences of fever/chill and nausea/vomiting were less common in Group I (P<0.05). The duration of prodromal symptoms in Group I (2.6 days) was longer than that of Group II (1.6 days, P=0.02), but was not significantly different from that of Group III (3.3 days, P=0.83). The mean WBC count was significantly smaller in Group I (10913.8/mm3) than in Group II (13238.3/mm3) and III (15589.3/mm3, P<0.001). The percentage of segment form in differential counts was smaller in Group I (73.6%) than in Group II (79.1%) and III (81.8%, P<0.001). The percentage of lymphocytes in differential counts was larger in Group I (17.7%) than in Group II (13.9%) and Group III (9.4%, P<0.001).CONCLUSIONS:
Among the patients who complain of pain in the right lower quadrant abdomen in an emergency setting, cecum and right-sided colonic diverticulitis must be considered in the following conditions to avoid unnecessary emergency operations, relatively younger patients (20~40 years), infrequent prodromal symptoms, absent rebound tenderness with a laterally deviated maximal tenderness point, and absent or mild leucocytosis with a relatively low fraction of segment forms associated with a higher fraction of lymphocytes in CBC.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Apendicitis
/
Razón de Masculinidad
/
Linfocitos
/
Ciego
/
Registros Médicos
/
Incidencia
/
Estudios Retrospectivos
/
Colon
/
Diagnóstico
/
Diverticulitis del Colon
Tipo de estudio:
Estudio diagnóstico
/
Estudio de incidencia
/
Estudio observacional
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Coreano
Revista:
Journal of the Korean Society of Coloproctology
Año:
2005
Tipo del documento:
Artículo
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