Isolated cecal necrosis: our surgical experience and a review of the literature
Ekrem Çakar1, Feyzullah Ersöz1, Murat Bag2, Savaş Bayrak1, Şükrü Çolak1, Hasan Bektaş1, M. Emin Güneş1, Emel Çakar3
1Clinic of General Surgery, İstanbul Training and Research Hospital, İstanbul, Turkey
2Clinic of General Surgery, Kocaeli State Hospital, Kocaeli, Turkey
3Department of Nursing, İstanbul Gelişim University, İstanbul, Turkey
Abstract
Objective: Isolated cecal necrosis is a rare cause of ischemic colitis. Ischemic colitis is further divided into two groups: occlusive mesenteric ischemia and non-occlusive mesenteric ischemia. The aim of this study was to investigate the cause of isolated cecal necrosis.
Material and Methods: We operated on 3 male and 3 female patients with a mean age of 60.3±18.7 (38-85) years with a preliminary diagnosis of acute appendicitis between 2007 and 2012. Four of these patients were on hemodialysis, 1 patient had an aortofemoral bypass, and 1 patient had coronary artery disease with atrial fibrillation.
Results: The diagnosis was made intraoperatively in all cases. Five patients died postoperatively. One patient survived.
Conclusion: In the case of right lower quadrant pain, the possibility of isolated cecal necrosis should be kept in mind, especially in patients on hemodialysis, elderly patients with diabetes, and heart disease; surgical strategies should be planned accordingly, and it should be understood that a high mortality rate will be inevitable.
Keywords: Isolated cecal necrosis, non-occlusive mesenteric ischemia, appendicitis
This is a retrospective study. There is no application to the ethics committee.
Written informed consent was obtained from patients who participated in this study.
Externally peer-reviewed.
Concept - E.Ç., F.E.; Design - E.Ç., F.E., M.B.; Supervision - F.E., S.B., H.B.; Funding - Ş.Ç., Em.Ç., M.E.G.; Materials - E.Ç., F.E.; Data Collection and/or Processing - S.B., Ş.Ç., Em.Ç.; Analysis and/or Interpretation - E.Ç., F.E., H.B.; Literature Review - M.B., M.E.G., Em.Ç.; Writer - E.Ç., F.E.; Critical Review - M.B., S.B., H.B.; Other - M.E.G., Ş.Ç.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.