Chapter 19 - Diverticular Disease of the Caecum, Ascending and Transverse Colon

Abstract

This chapter describes diverticular disease of the cecum. Diverticulitis of the cecum, ascending and transverse colon may be a part of a generalized disease process that involves the whole of the large bowel down to and sometimes including even the rectum. Caecal diverticula are caused by local factors independent of those that lead to diverticular disease of the sigmoid. Diverticula of the cecum, ascending and transverse colon, which are not inflamed usually, cause no symptoms. Patients with diverticula confined to the cecum and ascending colon may suffer recurrent episodes of mild abdominal pain at regular intervals. Acute diverticulitis of the cecum and ascending colon is usually indistinguishable clinically from acute appendicitis. Examination reveals tenderness in the right iliac fossa or right upper quadrant of the abdomen. Tenderness may be elicited on the right side by the finger on rectal examination. A palpable mass may be present if an abscess is formed. A high proportion of those with diverticulosis of the cecum and ascending colon pass occult blood, have frank melena or suffer a massive hemorrhage.