[Diverticula of the right colon. The diagnosis and treatment of complications].

BACKGROUND

Diverticula are localized in the right colon with a rate of 6.7-14% in Western countries. Two types of diverticula have been described in the right colon, on the basis of etiologic and pathological features: multiple diverticula and solitary diverticulum of the caecum. The most common clinical presentation of the right-sided colonic diverticula is an acute inflammatory complication, which is difficult to distinguish from other causes of right iliac fossa pain.

METHODS

A survey of the literature is presented and personal experience relative to 4 cases of acute diverticulitis of the right colon observed over a 10-year period is described.

RESULTS

In all the patients the preoperative diagnosis was acute appendicitis. In two cases the poor clinical conditions of the patients were associated with the free perforation of a solitary caecal diverticulum and diffuse faecal peritonitis. A temporary caecostomy was therefore required. In two cases a localized inflammatory mass was found around a perforated solitary diverticulum of the caecum. An ileocaecal resection was performed.

CONCLUSIONS

The purpose of this study is to emphasize the epidemiological, etiologic and clinical features of right-sided colonic diverticula, and the diagnostic and therapeutic management of their complications.