A CASE OF RIGHT COLONIC DIVERTICULITIS COMPLICATED WITH A MOBILE CECUM

Abstract

A 40-year-old man was admitted to the hospital because of left lower abdominal pain. Severe tenderness and muscular guarding were noted in the left lower quadrant of the abdomen. Ultrasonography revealed thickening intestinal wall and hypoechoic masses containing spotty hyperechoic lesions protruded from the wall at the point of tenderness. The intestinal lesions were thought to be diverticulitis of the colon. The intestine was connected to the transverse colon via hepatic flexure and thought to be the right colon. Abdominal CT revealed the same findings. We diagnosed the case as right colonic diverticulitis complicated with a mobile cecum and treated with conservative therapy. Barium enema performed after discharge from the hospital confirmed the diagnosis. Right colonic diverticulitis is frequently misdiagnosed with acute appendicitis due to the resemble symptoms and signs. The diagnosis would be more difficult when the mobile cecum coexisted because the area of abdominal tenderness would migrate. Ultrasonography and CT scan are useful in the diagnosis of right colonic diverticulitis with a mobile cecum, because they can visualize the pathological change and location of the lesion.