Isolated cecal necrosis mimicking acute appendicitis: a case series
<p>Abstract</p> <p>Introduction</p> <p>Spontaneous non-occlusive ischemic colitis involving the cecum alone (isolated cecal necrosis) is a rare condition that is generally due to a low-flow state: shock. It presents with right lower quadrant abdominal pain and may resem...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2009-06-01
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| Series: | Journal of Medical Case Reports |
| Online Access: | http://www.jmedicalcasereports.com/content/3/1/7443 |
| _version_ | 1818787882097180672 |
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| author | Dirican Abuzer Unal Bulent Bassulu Nuray Tatlı Faik Aydin Cemalettin Kayaalp Cuneyt |
| author_facet | Dirican Abuzer Unal Bulent Bassulu Nuray Tatlı Faik Aydin Cemalettin Kayaalp Cuneyt |
| author_sort | Dirican Abuzer |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Spontaneous non-occlusive ischemic colitis involving the cecum alone (isolated cecal necrosis) is a rare condition that is generally due to a low-flow state: shock. It presents with right lower quadrant abdominal pain and may resemble acute appendicitis. Little is known about postoperative ischemic necrosis of the remaining colon after surgical treatment of isolated cecal necrosis. We report four cases of isolated cecal necrosis mimicking acute appendicitis seen at our institution within a 4-year period.</p> <p>Case presentation</p> <p>The patients were two men and two women with a mean age at diagnosis of 59 years (range 46-68). The patients were of Turkish ethnic origin. All patients presented to the emergency room with acute abdominal pain and had symptoms of nausea and vomiting. The medical histories for three of the patients revealed end-stage renal failure requiring hemodialysis. The other patient had chronic obstructive pulmonary disease. Right hemicolectomy with anastomosis was performed in three patients and cecal resection with ileocolostomy was performed in the remaining one patient. All of the patients healed without complications. Median follow-up of patients was 24.5 (range: 17-37) months. There was no recurrence of ischemia in the remaining colon during the follow-up period of the patients.</p> <p>Conclusion</p> <p>Isolated cecal infarction should be included in the differential diagnosis of acute pain in the right lower quadrant of the abdomen, especially in those patients on chronic hemodialysis. While diffuse ischemic disease of the intestine has high morbidity, mortality and recurrence rates, patients with isolated cecal necrosis have a good prognosis with early diagnosis and surgical treatment compared to those with diffuse ischemic disease.</p> |
| first_indexed | 2024-12-18T14:14:50Z |
| format | Article |
| id | doaj.art-a56e0bb5501d4c79877316b8e5793913 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-18T14:14:50Z |
| publishDate | 2009-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-a56e0bb5501d4c79877316b8e57939132022-12-21T21:05:03ZengBMCJournal of Medical Case Reports1752-19472009-06-0131744310.4076/1752-1947-3-7443Isolated cecal necrosis mimicking acute appendicitis: a case seriesDirican AbuzerUnal BulentBassulu NurayTatlı FaikAydin CemalettinKayaalp Cuneyt<p>Abstract</p> <p>Introduction</p> <p>Spontaneous non-occlusive ischemic colitis involving the cecum alone (isolated cecal necrosis) is a rare condition that is generally due to a low-flow state: shock. It presents with right lower quadrant abdominal pain and may resemble acute appendicitis. Little is known about postoperative ischemic necrosis of the remaining colon after surgical treatment of isolated cecal necrosis. We report four cases of isolated cecal necrosis mimicking acute appendicitis seen at our institution within a 4-year period.</p> <p>Case presentation</p> <p>The patients were two men and two women with a mean age at diagnosis of 59 years (range 46-68). The patients were of Turkish ethnic origin. All patients presented to the emergency room with acute abdominal pain and had symptoms of nausea and vomiting. The medical histories for three of the patients revealed end-stage renal failure requiring hemodialysis. The other patient had chronic obstructive pulmonary disease. Right hemicolectomy with anastomosis was performed in three patients and cecal resection with ileocolostomy was performed in the remaining one patient. All of the patients healed without complications. Median follow-up of patients was 24.5 (range: 17-37) months. There was no recurrence of ischemia in the remaining colon during the follow-up period of the patients.</p> <p>Conclusion</p> <p>Isolated cecal infarction should be included in the differential diagnosis of acute pain in the right lower quadrant of the abdomen, especially in those patients on chronic hemodialysis. While diffuse ischemic disease of the intestine has high morbidity, mortality and recurrence rates, patients with isolated cecal necrosis have a good prognosis with early diagnosis and surgical treatment compared to those with diffuse ischemic disease.</p>http://www.jmedicalcasereports.com/content/3/1/7443 |
| spellingShingle | Dirican Abuzer Unal Bulent Bassulu Nuray Tatlı Faik Aydin Cemalettin Kayaalp Cuneyt Isolated cecal necrosis mimicking acute appendicitis: a case series Journal of Medical Case Reports |
| title | Isolated cecal necrosis mimicking acute appendicitis: a case series |
| title_full | Isolated cecal necrosis mimicking acute appendicitis: a case series |
| title_fullStr | Isolated cecal necrosis mimicking acute appendicitis: a case series |
| title_full_unstemmed | Isolated cecal necrosis mimicking acute appendicitis: a case series |
| title_short | Isolated cecal necrosis mimicking acute appendicitis: a case series |
| title_sort | isolated cecal necrosis mimicking acute appendicitis a case series |
| url | http://www.jmedicalcasereports.com/content/3/1/7443 |
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