Korean J Gastroenterol.  2013 May;61(5):265-269. 10.4166/kjg.2013.61.5.265.

Ischemic Necrosis of the Cecum: A Single Center Experience

• Gundes E
• Kucukkartallar T
• Colak MH
• Cakir M
• Aksoy F

• KMID: 1501648
• DOI: http://doi.org/10.4166/kjg.2013.61.5.265

Abstract

BACKGROUND/AIMS
Isolated cecal necrosis is a rare cause of the surgical abdomen. Its manifestation is similar to that of acute appendicitis. Thirteen cases, who were pre-diagnosed with acute abdomen and were finally diagnosed with isolated cecal necrosis after operation have been evaluated alongside with literature.
METHODS
The records of 13 patients, who had isolated cecal necroses between 1995 and 2011 at Necmettin Erbakan University Meram Medical School's General Surgery Clinic (Turkey), were retrospectively evaluated.
RESULTS
Eight of the patients were male, whereas 5 were female. Their mean age was 68.0+/-11.7 (range 51-84) years. All the patients had at least one accompanying disease the most frequent of which were heart failure and chronic renal failure. Ten patients had right hemicolectomy and ileotransversostomy, two had right hemicolectomy and ileostomy, and one had wedge resection to the cecum by the help of linear stapler. Mortality was seen in 5 patients (38%) in the early postoperative period.
CONCLUSIONS
Isolated cecal necrosis should be considered in elderly patients with chronic diseases presenting with sudden right lower quadrant pains in the differential diagnosis. Isolated cecal necrosis may have a bad prognosis since it is seen in elderly patients with accompanying problems. Therefore, early diagnosis and immediate surgical management if necessary is important to reduce the risk of morbidity and mortality.

Keyword

Appendicitis; Cecum; Necrosis; Colectomy

MeSH Terms

Age Factors
Aged
Aged, 80 and over
Cecum/*pathology
Colectomy
Female
Heart Failure/etiology
Humans
Ileostomy
Male
Middle Aged
Necrosis/*diagnosis/mortality/surgery
Renal Insufficiency, Chronic/etiology
Retrospective Studies

Figure

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  Fig. 1. Ischemic field (3×5 cm) on the cecal lateral wall.

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  Fig. 2. Ischemic outlook covering almost the entire cecum.

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  Fig. 4. (A) Ischemic field (2×2 cm) on the cecal anterior wall. (B) Cecal wedge resection material by the help of stapler. (C) The outlook of the cecum following resection with stapler.

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  Fig. 3. Right hemicolectomy was performed because of cecal necrosis.

Reference

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