A Rare Entity: Coexistence of Acute Appendicitis and Cecal Diverticulitis

Year 2024, Volume: 4 Issue: 1, 30 - 33, 22.04.2024

Harun Bayram , Tolga Kalaycı

https://doi.org/10.58961/hmj.1419585

Abstract

In this case report, we wanted to present the diagnostic and treatment process of a patient who was diagnosed with acute appendicitis in the preoperative period, was taken to surgery, and was diagnosed with cecum diverticulitis in the perioperative period. A 36-year-old female patient was admitted to our emergency department with complaints of abdominal pain, nausea, and loss of appetite for 3 days. Abdominal pain started in the lower right abdomen and gradually increased in severity as the day passed. On physical examination, there was defense and rebound localized to the lower right quadrant of the abdomen. In the laboratory, the white blood cell count was within normal limits (7.4 10*9 L-1) and the c-reactive protein (CRP) level was 79 mg L-1 (0-5 mg L-1). On abdominal ultrasonography, the diameter of the appendix vermiformis was measured as 8.5 mm, and it was observed that there was increased echogenicity in the fatty tissue around the appendix vermiformis. The patient was taken to emergency surgery. During exploration, the appendix was observed to be oedematous. Additionally, diverticulitis was observed in the anterior wall of the cecum, close to the ileocecal area. Simultaneous appendectomy and diverticulectomy were performed. The patient was discharged without complications on the 4th postoperative day.

Keywords

Appendicitis, Colonic diverticulitis, Operative procedure

Nadir Bir Durum: Akut Apandisit ve Çekal Divertikülitin Birlikteliği

Abstract

Bu olgu sunumunda ameliyat öncesi dönemde akut apandisit tanısı konularak ameliyata alınan ve perioperatif dönemde çekum divertiküliti tanısı konulan bir hastanın tanı ve tedavi sürecini sunmak istedik. 36 yaşında kadın hasta, 3 gündür devam eden karın ağrısı, bulantı, iştahsızlık şikayetiyle acil servisimize başvurdu. Karın ağrısı sağ alt karın bölgesinde başladı ve gün geçtikçe şiddeti giderek arttı. Fizik muayenesinde batın sağ alt kadranda lokalize defans ve rebound mevcuttu. Laboratuvarda beyaz küre sayısı normal sınırlarda (7,4 10*9 L-1), C-reaktif protein (CRP) düzeyi 79 mg L-1 (0-5 mg L-1) idi. Batın ultrasonografisinde apendiks vermiformis çapı 8,5 mm olarak ölçüldü ve apendiks vermiformis çevresindeki yağ dokusunda ekojenitenin arttığı gözlendi. Hasta acil ameliyata alındı. Eksplorasyon sırasında apendiksin ödemli olduğu görüldü. Ayrıca çekum ön duvarında ileoçekal bölgeye yakın divertikülit gözlendi. Eş zamanlı apendektomi ve divertikülektomi yapıldı. Hasta ameliyat sonrası 4. günde komplikasyonsuz olarak taburcu edildi.

Keywords

Apandisit, Kolon divertiküliti, Ameliyat prosedürü

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