%0 Journal Article
%T Caecal diverticulitis presenting as acute appendicitis: a case report
%A Michelle Cole
%A Abraham A Ayantunde
%A John Payne
%J World Journal of Emergency Surgery
%D 2009
%I BioMed Central
%R 10.1186/1749-7922-4-29
%X We report a case of a 61 year old Caucasian who presented with acute onset right iliac fossa pain indistinguishable from acute appendicitis. The true diagnosis of a perforated acute caecal diverticulitis with an abscess mass was only made at operation in the presence of a macroscopically normal appendix. We reviewed the literature to highlight the difficulty of a preoperative diagnosis and the need for a high index of suspicion especially in the older age group presenting in manner similar to acute appendicitis.Solitary caecal diverticulum is an uncommon entity and therefore difficult to diagnose except at surgery. It is rare in the Western world among the Caucasians but has been shown to have a high incidence in the people of Asian origin or Oriental populations [1,2]. Caecal diverticulum is an infrequent cause of acute abdomen and caecal diverticulitis usually presents in a manner similar to acute appendicitis [3]. It is extremely difficult to differentiate it preoperative from acute appendicitis and such distinction is usually made in the operating room [4]. It is sometimes confused with caecal pole tumour when it presents with a right iliac fossa mass in the older age group [5]. There have been various debates in the literature about the most appropriate and optimal management of symptomatic solitary caecal diverticulum or caecal diverticulitis. Some studies have suggested a conservative approach, a wedge resection of the diverticulum, right hemicolectomy or ileo-caecal resection [1-4,6].We report a case of solitary caecal diveticulitis presenting as an acute appendicitis to highlight the dilemma in preoperative diagnosis and present the review of the literature on the investigations and management debates and diversity.A 61 year old Caucasian man presented to our Accident and Emergency unit with a day history of right iliac fossa pain associated with fever and rigors. The appetite was reduced but no nausea or vomiting. The pain was said to be constant and sharp
%U http://www.wjes.org/content/4/1/29