Annals of Coloproctology

The Korean Society of Coloproctology (대한대장항문학회)
권호 표지

Clinical Analysis of 42 Cases Who Underwent Colectomy for Suspected Acute Appendicitis

급성 충수염 의증으로 결장 절제술을 시행한 42예의 환자에 대한 임상적 관찰

Yoon, Ho-Young;Kim, Byung-Chun
윤호영;김병천

  • Published : 2005.12.30
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Abstract

Purpose: When patients underwent emergency surgery for suspected appendicitis, colon resection could be performed at the time of the initial operation. The aim of this study was to evaluate 42 cases underwent colectomy for suspected acute appendicitis. Methods: A retrospective analysis of 42 patients underwent colectomy for suspected acute appendicitis was performed over the period from January 1997 to December 2003 at the department of surgery, Kangnam Sacred Heart hospital, Hallym university. Results:The sex ratio were 1.2：1. The mean age was 37.7 years. Right lower quadrant pain was present in all patients. Nausea and vomiting occurred in 18 cases (42.8%). Preoperative fever was 11 cases (26.1%). Abdominal ultrasound was most commonly performed preoperatively. The operative findings showed cecal mass with pericecal abscess was 20 cases (47.5%) and cecal mass with inflammation, 11 cases (26.1%), etc. The pathologic findings showed cecal diverticular abscess was 18 cases (42.8%) and pericecal abscess, 9 cases (21.4%), periappendiceal abscess, 5 cases (11.9%), etc. Type of operation was ileocecectomy, 29 cases (69.04%), and right hemicolectomy, 12 cases (28.57%), and extended right hemicolectomy, 1 case. Postoperative complications developed in 12 cases (28.57%), but those were uneventful. Conclusions: When an unexpected and suspicious cecal mass was found at operation for suspected appendicitis, the resection of all clinically apparent disease including colectomy could be considered. So, the surgeon must be aware of the possibility of these condition and choose the appropriate treatment.

Keywords

References

  1. Graham SM, Ballantyne GH. Cecal diverticulitis, a review of the American experience. Dis Colon Rectum 1987;30:821-6 https://doi.org/10.1007/BF02554637
  2. Lane JS, Sarkar R, Schmit PJ, Chandler CF, Thompson JE Jr. Surgical approach to cecal diverticulitis. J Am Coll Surg 1999;188:629-34 https://doi.org/10.1016/S1072-7515(99)00043-5
  3. Schmit PJ, Bennion RS, Thompson JE. Cecal diverticulitis: a continuing diagnostic dilemma. World J Surg 1991;15:367-71 https://doi.org/10.1007/BF01658730
  4. Harada RN, Whelan TJ Jr. Surgical management of cecal diverticulitis. Am J Surg 1993;166:666-71 https://doi.org/10.1016/S0002-9610(05)80676-2
  5. Young-Fadok TM, Roberts PL, Spencer MP, Wolff BG. Colonic diverticular disease. Curr Probl Surg 2000;37:459-514
  6. Sardi A, Gokli A, Singer JA. Diverticular disease of the cecum and ascending colon, a review of 881 cases. Am J Surg 1987;53:41-5 https://doi.org/10.1016/S0002-9610(41)90448-8
  7. Laimon H, Cohn P. Diverticulitis of cecum. Am J Surg 1962;103;146-9 https://doi.org/10.1016/0002-9610(62)90031-4
  8. 김 욱, 이도상, 서영진, 조원일, 오승택, 진형민 등. 맹장 게실염. 대한외과학회지 1995;50:116-21
  9. 조현준, 조승연, 오재환. 급성 충수염 의증으로 수술한 우측 대장게실염 환자에 대한 임상적 고찰. 대한대장항문학회지 2000;16:18-24
  10. 박철운, 김봉구, 김기상, 변영훈, 조광호, 변상현 등. 충수염 진단하에 개복 수술 중 발견한 맹장 게실염의 수술적 치료. 대한대장항문학회지 2001;17:15-9
  11. Schwerk WB, Schwartz S, Rothmund M. Sonography in acute colonic diverticulitis; a prospective study. Dis Colon Rectum 1992;35:1077-84 https://doi.org/10.1007/BF02252999
  12. Schuler JG, Bayley J. Diverticulitis of the cecum. Surg Gynecol Obstet 1983;156:743-8
  13. Asch MJ, Markowitz AM. Cecal diverticulits: report of 16 cases and a review of the literature. Surgery 1969;65:906-10
  14. Fisher MG, Farkas AM. Diverticulitis of the cecum and ascending colon. Dis Colon Rectum 1984;27:454-8 https://doi.org/10.1007/BF02555537
  15. Fang JF, Chen RJ, Lin BC, Hsu YB, KAo JL, Chen MF. Aggressive resection is indicated for cecal diverticulitis. Am J Surg 2003;185:135-40 https://doi.org/10.1016/S0002-9610(02)01209-6
  16. Sugihara K, Muto T, Morioka Y, Asano A, Yamamoto T. Diverticular disease of the colon in Japan. Dis Colon Rectum 1984;27:531-7 https://doi.org/10.1007/BF02555517
  17. 송준호, 백종대, 이상희, 김한선. 급성 복증을 동반한 대장 게실염의 임상양상. 대한대장항문학회지 2002;18:390-6
  18. Bahadursingh AM, Virgo KS, Kaminski DL, Longo WE. Spectrum of disease and outcome of complicated diverticular disease. Am J Surg 2003;186:696-701 https://doi.org/10.1016/j.amjsurg.2003.08.019
  19. Arrington P, Judd CS Jr. Cecal diverticulitis. Am J Surg 1981;142:56-9 https://doi.org/10.1016/S0002-9610(81)80012-8
  20. Ngoi SS, Chia J, Goh MY, Sim E, Rauff A. Surgical management of right colon diverticulitis. Dis Colon Rectum 1992;35:799-802 https://doi.org/10.1007/BF02050332
  21. Lauridsen J, Ross FP. Acute diverticulitis of the cecum. Arch Surg 1952;64:320-4 https://doi.org/10.1001/archsurg.1952.01260010334007
  22. Schoetz DJ. Diverticular disease of the colon. Dis Colon Rectum 1999;42:703-9 https://doi.org/10.1007/BF02236921