IS case 524: Cecal diverticulitis
Imaging Sciences URMC 2010
Publication Date: 2010-09-10
Right colon diverticulitis is a relatively rare disease more commonly seen in the Asian or African population. Clinically, the entity resembles left colon diverticulitis with symptoms on the right and is a great mimicker of acute appendicitis. Right colon diverticula are congenital, more commonly in the cecum, and usually solitary in contrast to left colon diverticula which develop and increase in number with age and are associated with certain risk factors such as low fiber intake.
Image findings on CT include right lower quadrant infiltrative changes surrounding the inflamed diverticula with or without colon wall thickening or adjacent abscess. The diagnosis is difficult to make as diverticula may be obscured by adjacent inflammatory changes and the entity may be indistinguishable from colon cancer in an older population. Also, since appendicitis more commonly causes right lower quadrant inflammatory changes visualization of a normal appendix is essential for CT diagnosis. Other than appendicitis and colon cancer the differential diagnosis includes Crohn’s disease and epiploic appendigitis.
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