{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T16:44:59Z","timestamp":1726505099742},"reference-count":6,"publisher":"California Digital Library (CDL)","issue":"1","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: The perforation of a cecal diverticulum is a rare and challenging condition for the emergency physician.\nCase Report: A 47-year-old man with a past surgical history of bilateral inguinal hernia repair presented to the emergency department (ED) with acute abdominal pain of three days\u2019 duration. Pain was localized to the right lower quadrant (RLQ), with anorexia as the only associated symptom. Upon arrival to the ED, his exam demonstrated focal RLQ tenderness to palpation, rebound tenderness, and guarding. Labs did not show any elevation in inflammatory markers, liver enzymes, or lipase. Computed tomography showed no evidence of acute appendicitis, colitis, or hernia recurrence. After morphine and reassessment, the patient still had a focal peritoneal exam in the RLQ. Surgical consultation was obtained and recommended additional non-opioid analgesia as well as serial abdominal exams. After several repeat abdominal exams, there was no change in the focality of the patient\u2019s pain. Surgery was reconsulted and opted to take the patient to the operating room for exploratory laparoscopy with \u201cappendicitis\u201d as the presumptive diagnosis. Pathology report revealed a perforated cecal diverticulum that was adherent to the abdominal wall. The patient did well and was discharged on his third postoperative day.\nConclusion: This case further underlines that even in the era of sensitive imaging tools, the diagnostic value of a targeted physical exam with clinical re-evaluation can never be overestimated.<\/jats:p>","DOI":"10.5811\/cpcem.2021.11.53795","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T04:46:37Z","timestamp":1644295597000},"page":"73-75","source":"Crossref","is-referenced-by-count":0,"title":["An Unusual Case of Right Lower Quadrant Pain: A Case Report"],"prefix":"10.5811","volume":"6","author":[{"given":"Sarah","family":"Jabre","sequence":"first","affiliation":[{"name":"Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Supino","sequence":"additional","affiliation":[{"name":"Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Zuckerman J, Garfinkle R, Vasilevksy C-A, et al. Short- and long-term outcomes of right-sided diverticulitis: over 15 years of North American experience. World J Surg. 2020;44(6):1994-2001.","DOI":"10.1007\/s00268-020-05431-3"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Radhi JM, Ramsay JA, Boutross-Tadross O. Diverticular disease of the right colon. BMC Res Notes. 2011;4(1):383.","DOI":"10.1186\/1756-0500-4-383"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Yildar M, Ozkan OF, Caglayan K, et al. An unusual cause of right lower quadrant pain: the caecum diverticulitis. Case Rep Surg. 2012;2012:789397.","DOI":"10.1155\/2012\/789397"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Cristaudo A, Praga P, Sanjeev N. Caecal diverticulitis: presentation and management. Ann. Med. Surg. 2015;4(1):72-5.","DOI":"10.1016\/j.amsu.2015.02.002"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Wagner D and Zollinger R. Diverticulitis of the cecum and ascending colon. Arch Surg. 1961;83:436-43.","DOI":"10.1001\/archsurg.1961.01300150110014"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Kumar S, Fitzmaurice GJ, O\u2019Donnell ME, et al. Acute right iliac fossa pain: not always appendicitis or a caecal tumour: two case reports. Cases J. 2009;2(1):88.","DOI":"10.1186\/1757-1626-2-88"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T19:50:10Z","timestamp":1645818610000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/1bw6w4hc"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,28]]},"references-count":6,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,2,3]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2021.11.53795","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2022,1,28]]}}}