Abstract
Right colon diverticulitis is a disease that should be distinguished from acute appendicitis, but no effective differential diagnosis has yet been found. Recently, while employing ultrasonic diagnosis in patients with acute abdominal disease and pain in the right lower abdominal area, we were able to diagnose four cases of right colon diverticulitis. These were clearly different from the ultrasonic images of appendicitis. The findings could be characterized, and were considered to be sufficiently recognizable objectively. The ultrasonic findings may be summarized as 1) a small hyperechoic region estimated to indicate the intradiverticular cavity, 2) a nearly concentric hypoechoic area showing an intense inflammatory region of the diverticular wall and its surroundings (considered to suggest peripheral inflammation or a periphereal abscess), and 3) a hyperechoic area with a rather indistinct boundary believed to indicate propagation of the inflammation to the hypoechoic area at the posterior peritoneal side of the mesentery surrounding regions 1) and 2). Right colon diverticulitis is difficult to distinguish from acute appendicitis, and emergency laparotomy is often applied.
However, if correctly diagnosed as diverticulitis, most cases can be cured by conservative treatment, and unnecessary invasive operations can be avoided. Ultrasonic diagnosis will become an important objective diagnostic method.
