A Rare Cause of Right Lower Quadrant Abdominal Pain: Isolated Cecal Necrosis

• Published in: Turkish journal of colorectal disease Vol. 32; no. 1; pp. 31 - 35
• Main Authors: Demirli Atıcı, Semra, Üstün, Mehmet, Avcı, Emran Kuzey, Kaya, Tayfun, Çalık, Bülent
• Format: Journal Article
• Language: English
• Published: Mersin Galenos Publishing House 01-03-2022
• Subjects: Abdomen; Cardiovascular disease
• ISSN: 2536-4898; 2536-4901
• DOI: 10.4274/tjcd.galenos.2021.2020-8-5

Aim: Isolated cecal necrosis (ICN), a variant of ischemic colitis, is a rarely seen clinical condition. This aim of this case series was to evaluate the diagnosis and management of ICN. Method: Patients operated between December 2013-January 2020 with the presumptive diagnosis of acute abdomen and intra-operatively diagnosed as ICN were evaluated retrospectively. Results: There were 17 patients of whom nine (52.9%) were male. The mean age of the patients was 55.8 (range: 22-85) years. All the patients had at least one co-morbid disease, the most frequent of which were coronary artery disease, hypertension, and chronic renal failure. Fourteen (82.35%) underwent right hemicolectomy, and ileotransversostomy, while two (11.8%) had right hemicolectomy and Mikulicz ileocolostomy, and one (5.9%) underwent partial colonic resection with Mikulicz ileocolostomy due to limited cecal necrosis, which was diagnosed earlier. Six (35.3%) patients died. Conclusion: ICN must be kept in mind in the differential diagnosis of acute abdomen with right lower quadrant localization, especially in patients with co-morbid diseases. Due to delayed diagnosis and complications, such as perforation, ICN had a high rate of morbidity and mortality.