A rare cause of acute abdomen: Isolated necrosis of the cecum

急性腹痛的一种罕见病因:盲肠孤立性坏死。

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Abstract

OBJECTIVE: We aimed to present a 76-year-old female patient with cecal necrosis, which is a rare cause of acute abdomen in elderly women and a variant of ischemic colitis. MATERIALS AND METHODS: The patient was admitted to hospital with abdominal pain, anorexia and nausea. Physical examination, laboratory parameters and abdominal computed tomography revealed acute abdomen. We operated the patient with below umbilical midline incision. Although the pain localized to the right lower quadrant made us consider acute appendicitis as first diagnosis, other pathologies were also kept in mind for differential diagnosis. RESULTS: Non-occlusive cecal necrosis was determined, and terminal ileum and cecum resection and Meckel’s diverticulum excision were performed. Arterial pulsation was palpated, and no sign of thrombus was found. CONCLUSIONS: Isolated necrosis of the cecum may be due to multiple reasons. Especially in elderly female patients with predisposing factors like hypotension, sepsis, shock, drug use, vasculitis, and hypercoagulability, cecum necrosis should be kept in mind.

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