Perforated diverticulum of the caecum. A difficult preoperative diagnosis. Report of 2 cases and review of the literature.Tech Coloproctol. 2004 Nov; 8 Suppl 1:s116-8.TC
Perforation of a solitary caecal diverticulum is a rare cause of acute abdomen and an uncommon differential diagnosis for acute appendicitis. Nine hundred cases have been described since Potiers' first description of perforated caecal diverticulum in 1912.
We describe 2 cases of perforated diverticulum of the caecum. The first patient was a 50-year-old man diagnosed by subsequent histology, and the second a 77-year-old woman diagnosed intra-operatively. Radiography, ultrasound and CT scan of the abdomen pointed at the diagnosis in the second case. A right hemicolectomy was performed.
There were no complications, apart from a transient faecal fistula in the first patient managed conservatively. In both patients histology revealed a perforated caecal diverticulum.
The surgeon must be familiar with the diagnosis and management of this rare, inflammatory benign caecal entity.