A 28-year-old previously healthy woman arrives in the emergency room complaining of 24 h of anorexia and nausea and lower abdominal pain that is more intense in the right lower quadrant than elsewhere. On examination she has peritoneal signs of the right lower quadrant and a rectal temperature of 38.38degC (101.8degF). At exploration through incision of the right lower quadrant, she is found to have a small, contained perforation of a cecal diverticulum. Which of the following statements regarding this situation is true?
Cecal diverticula must be differentiated from the more common variety of diverticula that are usually found in the left colon. Cecal diverticula are thought to be a congenital entity. The cecal diverticulum is often solitary and involves all layers of the bowel wall; therefore, cecal diverticula are true diverticula. Diverticula elsewhere in the colon are almost always multiple and are thought to be an acquired disorder. These acquired diverticula are really herniations of mucosa through weakened areas of the muscularis propria of the colon wall. The preoperative diagnosis in the case of cecal diverticulitis is "acute appendicitis" about 80% of the time. If there is extensive inflammation involving much of the cecum, an ileocolectomy is indicated. If the inflammation is well localized to the area of the diverticulum, a simple diverticulectomy with closure of the defect is the procedure of choice. To avoid diagnostic confusion in the future, the appendix should be removed whenever an incision is made in the right lower quadrant, unless operatively contraindicated.
Cecal diverticula are acquired disorders
Cecal diverticula are usually multiple
Cecal diverticula are mucosal herniations through the muscularis propria
Diverticulectomy, closure of the cecal defect, and appendectomy may be indicated
Liver