Diverticuli can occur the right colon but are uncommon. These can become inflamed and can rupture with abscess formation.


Types of diverticuli that can occur:

(1) false (similar to those seen in sigmoid colon) = more common type

(2) true, with all of the layers of the bowel wall present


Clinical and laboratory features:

(1) pain and/or tenderness in the right lower quadrant which may mimic acute appendicitis

(2) usually febrile

(3) usually leukocytosis

(4) variable nausea and vomiting

(5) variable anorexia


Imaging studies can be helpful in identifying the condition prior to surgery, showing:

(1) a normal appendix

(2) a pericolic inflammatory mass in the ascending colon cephalad to the ileocecal valve


Conservative management (rehydration, antibiotics) is indicated with all of the following:

(1) this is the patient's first episode

(2) the patient is clinically improving on a conservative regimen

(3) the episode is uncomplicated

(4) appendicitis is not a concern

(5) an adenoma or tumor in the cecum or ascending colon is not a concern

A right hemicolectomy can be performed if conservative management fails.


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