Perforation of Cecal Diverticulum after Appendectomy

Abstract

Solitary cecal diverticulum was first described by Potier in 1912. Although it is a rare condition, however, there is an increased prevalence in Asian populations. The cecal diverticula are usually asymptomatic, however, 10-20% of the cases become symptomatic due to complications. The most common diverticulum-related complication is diverticulitis. Other complications include perforation, hemorrhage, and rarely intestinal obstruction. To conclude, cecal diverticulum is a rare condition that usually presents itself with complications. It is mostly diagnosed perioperatively in the cases of acute appendicitis, and rarely preoperatively. Cecal diverticulitis is commonly misdiagnosed as acute appendicitis. This is why USG, CT, and MRI are commonly used in the preoperative diagnosis. There are very few cases that are confirmed to have both cecal diverticulitis and acute appendicitis. When the condition is majorly diagnosed perioperatively after an acute appendicitis diagnosis; it should be remembered that in the case of determining cecal diverticulitis during the appendectomy, the best course of action is to simultaneously apply diverticulectomy. In this case report, a 54-year male patient is presented, where a cecal diverticulum perforation developed in the early postoperative phase following the appendectomy. At the time of admission, the patient had the complaints of distension, extensive sensitivity, and rebound. The patient underwent laparotomy and the diverticulectomy was performed with a linear stapler. In this case, the presence of a combination of acute appendicitis and cecal diverticulitis was confirmed through histopathological examination.