Kwanseop Lee MD, Presenter: Nothing to Disclose

Young A Bae MD, Abstract Co-Author: Nothing to Disclose

Myung Joon Lee, Abstract Co-Author: Nothing to Disclose

In Jae Lee, Abstract Co-Author: Nothing to Disclose

Yul Lee MD, Abstract Co-Author: Nothing to Disclose

Sang Hoon Bae MD, Abstract Co-Author: Nothing to Disclose

The right colonic diverticulitis(RCD) is an important disease that should be differentiated with acute appendicitis in whom complaining right lower quadrant pain, especially in an Asian population. Findings and frequency of RCD is well evaluated in adults, but not in children. The purpose of this study is to evaluate the sonographic findings and frequency of right colonic diverticulitis in a pediatric population.

From March 1999 to February 2004, thirteen children were confirmed as RCD in a pediatric population using high-resolution sonography. During this period, 650 children was confirmed as acute appendicitis surgically and pathologically. We retrospectively reviewed the sonographic findings of these children. The final diagnosis of the diverticulitis was confirmed by CT and colon study(5 children), CT(5 children), colon study(2 children) and clinical course(1 child ). The initial clinical diagnosis was acute appendicitis in all patients.

The frequency of RCD in a pediatric population was one in 50 appendectomies. The sonographic findings were outpouched sac from the colon with inflamed surrounding fat and colonic wallthickening at the area of outpouching in all patients(100%). Of the 13 outpouched diverticular sac, 11 cases(85%) showed curvilinear hyperechoic arc with posterior shadowing(fecalith type) and 2 cases(15%) showed hypoechoic sac(hypoechoic type). All children showed increased color flow in the inflamed diverticular wall and surrounding fatty tissue(100%). The location of the inflamed diverticulum was ascending colon in 11(85%) and cecum(15%) in 2 children. The normal appendix were visible in 10 children(77%). The male to female ratio was 9:4. The mean age was 13.7 years. The initial clinical diagnosis was acute appendicitis in all patients. All children were successfully treated conservatively.

Right colonic diverticulitis in a pediatric population is not a rare condition than generally expected. Sonographic findings are quite unique and understanding of these findings will successfully diagnose preoperatively and can avoid unnecessary surgical intervention through successful conservative treatment.

Lee, K, Bae, Y, Lee, M, Lee, I, Lee, Y, Bae, S, Right Colonic Diverticulitis in a Pediatric Population: Sonographic Evaluation.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4413995.html