HEPATIC FLEXTURE OF COLON SERIES

A rectal examination revealed guaiac-negative stool. On physical examination, localized tenderness to palpation was elicited in the right abdomen. His temperature was 37.4☌, heart rate was 80 beats per minute, and blood pressure was 160/52 mm Hg. He reported no nausea, vomiting, obstipation, or constipation. He described it as being poorly localized, progressive, and unrelated to oral intake. Case reportĪ 43-year-old African American man presented to the hospital after experiencing a sudden onset of right flank pain, which had persisted for the previous 2 days. The authors have no relationship with any commercial entity that might represent a conflict of interest with the content of this article and attest that the data meet the requirements for informed consent and for the Institutional Review Boards. Our patient presented with a rare case of a perforated diverticular inflammatory mass with disease limited to the hepatic flexure. 5ĭiagnosing right-sided diverticulitis is challenging, and most lesions are found at laparotomy in a predominantly cecal distribution.

HEPATIC FLEXTURE OF COLON SERIES

The largest reported series come from Hong Kong 4 and Japan. 2,3 In Asia, right-sided diverticulitis, which primarily involves the cecum, is the rule rather than the exception. Right-sided diverticulitis constitutes only 0.9% to 1.7% of all colonic diverticula in Western populations. 1 The most common clinical presentation of diverticular disease in Western countries is left-sided, with extension to the right when diverticulosis of the entire colon is present. Accurate preoperative diagnosis is difficult but could prevent unnecessary laparotomy and bowel resection in many cases.ĭiverticular disease is being seen with greater frequency in the Western world and involves an increasingly younger patient population. Typical CT findings include an inflamed right colonic diverticulum, pericolonic inflammation or abscess, and colonic wall thickening. CT scanning can help facilitate the diagnosis of uncomplicated diverticulitis. The authors discuss the differences between true and false diverticula and review the literature regarding diagnosis and management of right-sided diverticula.Ĭonclusion: True right-sided diverticulitis often responds to conservative management with antibiotics, and recurrence is rare. A histologic examination revealed true diverticula with pericolonic abscess, serositis, and perforation. The mass was initially suspected to be perforated colon cancer and was resected during an emergency laparotomy. Computed tomography (CT) scans of his abdomen and pelvis showed a solitary mass in the hepatic flexure. Results and discussion: This paper describes the case of a patient who presented to the hospital because of a sudden onset of right flank pain. Although right-sided diverticulitis is seen regularly in Asia, it constitutes only a fraction of colonic diverticula cases in Western populations.

Introduction: Diverticular disease is a growing health problem in the Western world, where left-sided involvement is typical.

Hepatic flexture of colon