Right Colonic Diverticulitis: an Uncommon Disease in Western Countries

Abstract

Background and aims: Right colonic diverticulitis is not a frequent disease and its management is still controversial. In this study we describe our experience.

Material and Methods: We retrospectively reviewed all patients operated on because of a right colonic diverticulitis in our surgical unit. All patients were treated laparoscopically. Demographics, diagnostic and surgical results were recorded. Results: Between January 1994 and January 2007, 11 patients (7 males and 4 females) mean age 53±9 years (range 3968), ASA 1: 6 patients, ASA2: 4 patients, ASA3: one patient, and BMI 27.8 (range 25–31), had right colonic diverti-culitis. Four patients underwent emergency operations: one for peritonitis and three with an erroneous diagnosis of acute appendicitis ; seven were operated on electively. There were no deaths or complications. The mean postoperative hospital stay was 5.6 days (range, 3–9). After a mean follow-up of 6.3 years (range 1–13) all patients of this series are symptom-free.

Interpretation and conclusion: Right colon diverticulitis diagnosis remains difficult. A pre-operative imaging screening is necessary to successfully face this challenging disease. Laparoscopy is a safe and effective method to treat these patients. Colectomy should be considered a good therapeutic option for right colonic diverticulitis, although a conservative approach could be proposed in selected cases.

Key words:

• Laparoscopy
• diverticular disease
• right hemicolectomy
• right colon.

Additional information

Notes on contributors

C. Smadja

C. Smadja, M.D., Ph.D. Department of Digestive Surgery Hôpital Antoine Béclère 157 rue de la Porte de Trivaux 92141 Clamart Cedex France Assistance Publique-Hôpitaux de Paris and University Paris XI Tel.: [phone] Fax: [phone] E-mail: [email protected]