Right-sided diverticulitis: a difficult diagnosis.

We report 12 cases of right-sided diverticulitis from January 1985 to May 1995 at our community hospital. The preoperative diagnosis of appendicitis was made in 11 of these patients. Only one patient was correctly diagnosed preoperatively. The mean age of patients at presentation was 48 years (range, 34-69). Six patients were male, and six were female. Eight patients (73%) presented with fever, seven (64%) had symptoms for greater than 24 hours, and 100 per cent of the patients had an elevated white blood cell count. All of the patients underwent surgery, without bowel preparation. In all cases, a normal appendix with cecal, ascending, or proximal transverse colon diverticulitis was found. Ten patients received a right hemicolectomy, and two had a cecectomy. The mean duration of hospital stay was 7 days (range, 5-13). There were no postoperative wound infections or anastomotic breakdowns. We conclude that the preoperative diagnosis of right-sided diverticulitis is difficult and should be sought if a normal appendix is discovered at the time of surgery. Furthermore, surgical resection of the right colon without preoperative bowel preparation was a safe procedure without complication in this series.