Clinical difference between acute appendicitis and acute right-sided colonic diverticulitis

Abstract Background: The clinical presentations of acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are similar, but the usual treatment for each disease differs between surgical and conservative management. This study aimed to identify the clinical differences between AA and ARCD. Method: We performed a single-center retrospective case-control study on adult patients with AA and ARCD confirmed by computed tomography who had visited an emergency department between March 2018 and February 2019. The clinical variables, including past medical history, presented symptoms and signs, and laboratory findings were compared between the two groups. We subsequently performed a logistic regression analysis for differentiating ARCD from AA based on the results of univariate analyses. Results: A total of 222 (79%) and 59 (21%) patients were enrolled in the AA and ARSD groups, respectively. Logistic regression analysis revealed that factors associated with ARCD were a past history of diverticulitis [OR 141.691 (95% CI: 12.222 – 1642.601), p < 0.001], ketonuria [OR 0.268 (95% CI: 0.099 – 0.726), p = 0.010], anorexia [OR 0.037 (95% CI: 0.007 – 0.207), p < 0.001], and neutrophilia [OR 0.179 (95% CI: 0.062 – 0.519), p = 0.002]. Conclusion: Anorexia, neutrophilia, and ketonuria were predictors of AA and a history of diverticulitis was a predictor of ARCD.