Clinical Difference between Acute Appendicitis and Acute Right-Sided Colonic Diverticulitis.

Ji Ho Song,Seung Chul Lee,Han Ho Do,Jeong Hun Lee,Sanghun Lee,Yong Won Kim,Jun Seok Seo

doi:10.1155/2020/4947192

Abstract

Background Clinical presentations of acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are similar. However, the usual treatment for each disease differs between surgical and conservative management. The aim of this study was to identify clinical differences between AA and ARCD. Method We performed a single-center retrospective study on adult patients, with uncomplicated AA and ARCD confirmed by computed tomography, who visited an emergency department between March 2018 and August 2019. Clinical variables including past medical history, presented symptoms and signs, and laboratory findings were compared between the two groups. A logistic regression analysis was subsequently performed to differentiate ARCD from AA based on results of univariate analyses. Results A total of 212 (79.1%) and 56 (20.9%) patients were enrolled in AA and ARSD groups, respectively. Logistic regression analysis revealed that a past history of diverticulitis [OR: 102.679 (95% CI: 9.964–1058.055), p < 0.001] was associated with ARCD, while ketonuria [OR: 2.907 (95% CI: 1.091–7.745), p=0.033], anorexia [OR: 21.544 (95% CI: 3.905–118.868), p < 0.001], and neutrophilia [OR: 3.406 (95% CI: 1.243–9.336), p=0.017] were associated with AA. Conclusion Anorexia, neutrophilia, and ketonuria were predictors of AA while a history of diverticulitis was a predictor of ARCD.

Highlights

Acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are inflammatory diseases that occur near anatomical locations. eir clinical presentations are similar, making it difficult to differentiate between them [1,2,3]. e current standard treatment for each disease is different
A total of 231 cases of acute appendicitis and 74 cases of acute colonic diverticulitis cases were diagnosed by abdominal Computer tomography (CT) scans of adult patients
Multivariate analysis revealed that factors predictive of ARCD were past history of diverticulitis [odds ratios (ORs): 102.679, p < 0.001], anorexia [OR: 0.046, p < 0.001], ketonuria [OR: 0.344, p 0.033], and neutrophilia [OR: 0.294, p 0.017] (Table 3)

Summary

Introduction

Acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are inflammatory diseases that occur near anatomical locations. eir clinical presentations are similar, making it difficult to differentiate between them [1,2,3]. e current standard treatment for each disease is different. Abdominal image testing for each episode to differentiate between these two diseases can be a burden for the patient [6, 12]. In this respect, only a few studies have verified clinical differences between these two diseases [13, 14]. Logistic regression analysis revealed that a past history of diverticulitis [OR: 102.679 (95% CI: 9.964–1058.055), p < 0.001] was associated with ARCD, while ketonuria [OR: 2.907 (95% CI: 1.091–7.745), p 0.033], anorexia [OR: 21.544 (95% CI: 3.905–118.868), p < 0.001], and neutrophilia [OR: 3.406 (95% CI: 1.243–9.336), p 0.017] were associated with AA. Neutrophilia, and ketonuria were predictors of AA while a history of diverticulitis was a predictor of ARCD

Methods

Results

Conclusion