Diverticulitis colónica aguda derecha con diagnóstico por tomografía espiral multicorte. A propósito de un caso

Abstract

Diverticular disease of the colon is common in the elderly, especially those over 70 years of age, with an incidence greater than 63%. It is frequently diagnosed in patients presenting to the emergency with acute abdominal symptoms. The clinical presentation of acute diverticulitis ranges from mild abdominal pain to peritonitis with sepsis. Diverticulitis of the right colon (DCD) is an infrequent entity in western countries and frequent in Asian countries, constituting between 1% and 3.6% of all colonic diverticular diseases; it presents etiopathogenesis and complex symptoms not yet fully understood. It is clinically distinguished from left colon diverticulitis (DCI) and is usually accompanied by right lower quadrant or iliac fossa pain with vomiting, nausea, fever, and anorexia; which constitutes a presentation similar to acute appendicitis, for which an erroneous clinical diagnosis is common. The clinical diagnosis of DCD can be challenging, and imaging has become an essential tool to aid in diagnosis, assess disease severity, and assist in treatment planning. The presumptive diagnosis can often be made based solely on clinical features; however, images are necessary in presentations from the mildest to the most serious in order to rule out complications such as abscesses and perforations. That is why multislice spiral tomography (TEM) is the imaging procedure of choice for the diagnosis of diverticulitis.