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Right-sided Diverticular Disease of the Colon Which Required Operation Because of Frequent Flare-ups N. Ohmori 1 , S. Akimoto 1 , S. Kameoka 1 , T. Igarashi 1 , K. Hamano 1 1The Institute of Gastroenterology, Tokyo Women's Medical College pp.851-856
Published Date 1980/8/25
DOI https://doi.org/10.11477/mf.1403112745
  • Abstract
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 Diverticulitis of the right side of the colon has been said to have less serious complications than the left-sided one and can be controlled by conservative treatment. However, some diverticulitis of the right side of the colon also have been noted to have muscle abnormalities as seen in the left-sided diverticulitis. In these cases, conservative treatment may ameliorate patients' symptoms but tend to have flareup of symptoms or inflammation after excess eating and drinking, physical exhaution and stressful situation. Therefore, if there is marked organic change of the colon, they should be operated on.

 The patient was a 60 year-old male who was first seen by local medical doctor in December 1976 because of right upper quadrant abdominal pain and fever. A diagnosis of appendicitis was made and symptoms were resolved by treatment. In 1977, he had intermittent lower abdominal pain but the symptom responded to digestives. In March, 1978, he came to our institution because of right lower quadrant abdominal pain and fever (39℃) and a hand sized mass was found in the right lower quadrant and leukocytosis (9,100) was also noted. He was hospitalized and barium enema was performed after improving symptoms by concervative treatment. The barium enema disclosed multiple diverticulae, serration, ridigity of the wall and deformity in the cecum and ascending colon, therefore multiple diverticulitis of the right side of the colon was diagnosed and conservative treatment was continued, then he was discharged with remission.

 At the end of March 1979 he was again hospitalized with right lower quadrant abdominal pain, right lower quadrant mass, fever (39℃) and leukocytosis (17,000). It was felt that the patient had flare-up of the diverticulosis at that time. Because of frequent flare-ups of diverticulutis for over the last 4 years as well as marked organic change of the colon, the patient was felt to have surgical indication. Laparotomy was performed and it disclosed shortening of the cecum and ascending colon forming a hand-sized mass which was stiff as a cancerous tumor. Resected specimen showed rigid and deformed cecum with hypertrophic wall. Post-operative course was excellent and he could return to his normal life style 2 months after the operation.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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