Estado actual del tratamiento quirúrgico en la diverticulitis cecal aguda / Present state in the surgical treatment of acute cecal diverticulitis

ABSTRACT

BACKGROUND: Cecal acute diverticulitis is a rare disease with symptoms similar to acute appendicitis and is therefore difficult to diagnose. OBJECTIVES: To evaluate therapeutical conduct according to clinical for ms of presentation and the intraoperative findings. LOCATION Emergency Service of Clinical National Hospital. U.N.C. (Cordoba National University), and the ABC group. DESIGN: Retrospective observation. MATERIALS AND METHODS: Twenty-four patients with cecal diverticulitis were treated surgically, of which seventeen were men and seven were women with an average age of 47 years. The first group was formed with 16 patients and the second with 8. All patients presented abdominal pain, fever, nausea and vomiting when they were admitted, but one showed enterorrhagia and 2 abdominal distention and ileus. Physical examination produced pain and tenderness in RLQ, but in 6 peritoneum was not involved and in 4 a tumor was palpable in that region. Two patients, had a perforating acute abdominal condition. RESULTS: Sixteen right hemicolectomies were performed. In the remaining eight a cecostomy was decided. One patient died due to TEPA (Acute pulmonary thromboembolism). Abdominal wall abscesses appeared in six patients, and in four of them an incisional middle hernia appeared in postoperative period. CONCLUSIONS: We consider that in those patients presenting serious problems in deciding whether the inflammatory condition was benign or malignant, or when perforated cecal diverticulum with vascular compromise and subsequent cecal wall necrosis has been suspected, we believe that the resection is the best treatment.