Case Control Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2019; 7(12): 1393-1402
Published online Jun 26, 2019. doi: 10.12998/wjcc.v7.i12.1393
Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study
Yosuke Sasaki, Fumiya Komatsu, Naoyasu Kashima, Takahiro Sato, Ikutaka Takemoto, Sho Kijima, Tadashi Maeda, Takamasa Ishii, Taito Miyazaki, Yoshiko Honda, Nagato Shimada, Yoshihisa Urita
Yosuke Sasaki, Fumiya Komatsu, Naoyasu Kashima, Takahiro Sato, Ikutaka Takemoto, Sho Kijima, Tadashi Maeda, Takamasa Ishii, Taito Miyazaki, Yoshiko Honda, Nagato Shimada, Yoshihisa Urita, Department of General Medicine and Emergency Care, Toho University School of Medicine, Ota-ku, Tokyo 143-8541, Japan
Author contributions: Sasaki Y designed the research, collected data, and wrote the manuscript; Komatsu F and Kashima N collected data with Sasaki Y; Takemoto I and Kijima S assisted with data collection; Ishii T supervised data collection; Sato T, Maeda T, and Miyazaki T provided supervision and discussion as experts of infectious diseases; Honda Y and Shimada N provided supervision and discussion as surgeons; and Urita Y supervised the research and supervised statistical analyses.
Institutional review board statement: The ethics committee of Toho University Medical Center Omori Hospital approved the study’s protocol (M17057).
Informed consent statement: The center’s ethics committee approved waiver of individual informed consent subject to public announcement of the research because of the retrospective and noninvasive study design. Comprehensive consents were obtained by all participants.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yosuke Sasaki, MD, PhD, Assistant Professor, Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo 143-8541, Japan. yousuke.sasaki@med.toho-u.ac.jp
Telephone: +81-3-37624151 Fax: +81-3-37656518
Received: March 12, 2019
Peer-review started: March 13, 2019
First decision: March 19, 2019
Revised: April 13, 2019
Accepted: May 10, 2019
Article in press: May 11, 2019
Published online: June 26, 2019
Processing time: 107 Days and 4.6 Hours
Core Tip

Core tip: Right colonic diverticulitis is an important differential diagnosis of appendicitis in Asian countries because of the unusually high prevalence of right colonic diverticula; however, studies reporting clinical differentiation between appendicitis and right colonic diverticulitis are still limited. Our case-control study using a logistic regression model shows that nausea/vomiting [odds ratio (OR): 3.89] and anorexia (OR: 2.13) suggest that appendicitis is more likely. On the other hand, longer onset-to-visit interval (OR: 0.84), right lower quadrant pain (OR: 0.28), history of diverticulitis (OR: 0.034), and CRP level > 3.0 mg/dL (OR: 0.25) suggest that right colonic diverticulitis is more likely.