Acute Right-sided Colonic Diverticulitis is an Unusual Cause of Right Lower Quadrant Pain: A Retrospective Single-center Cohort Study

INTRODUCTION: Acute right lower quadrant pain is a common symptom in emergency departments. The most common etiology is acute appendicitis, while other causes may be overlooked. Acute right-sided colonic diverticulitis is one of them. It is usually seen in young male patients. Ultrasonography (USG) and computed tomography (CT) are used for radiologic diagnosis. The aim of this study was to investigate the diagnosis, treatment, and surgical management of right-sided colonic diverticulitis.
METHODS: Patients hospitalized in our clinic between 2018 and 2022 with a diagnosis of right-sided colonic diverticulitis were retrospectively analyzed. Age, gender, WSES grade, surgical status, laboratory values, intravenous antibiotic therapies, length of hospitalization, and mortality were evaluated.
RESULTS: Between 2018 and 2022, a total of 20 patients were followed with acute right-sided colonic diverticulitis. Twelve patients were diagnosed by imaging and clinical examination, while 4 patients (20%) were operated on with a prediagnosis of acute appendicitis, and right-sided colonic diverticulitis was detected perioperatively. All patients diagnosed with acute right-sided colonic diverticulitis in the emergency department and hospitalized were managed conservatively and did not require surgery.
DISCUSSION AND CONCLUSION: In the differential diagnosis of right-sided colonic diverticulitis and acute appendicitis, physical examination and laboratory values are insufficient. Radiologic imaging, especially USG and CT, is essential. Following diagnosis, right-sided colonic diverticulitis can be effectively managed with conservative treatment. In our study, all patients with a radiologic diagnosis were followed conservatively and did not require percutaneous drainage or surgery.