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- W2911495616 abstract "Purpose: Isolated cecal infarction is an uncommon entity, which can be due to vasculoocclusive or nonocclusive causes. Here we present a case of a healthy elderly female with abdominal pain who was found to have an isolated cecal gangrene. An 82 year old Caucasian female presented to the emergency room with the acute onset of right lower quadrant abdominal pain. Her medical history was pertinent only for well-controlled hypertension and a surgical history of a left breast lumpectomy. At the time of admission, the patient was febrile with no hemodynamic instability; lab values revealed only leukocytosis (WBC 13,800/mm with 90% neutrophils). Computed tomography-intended to rule out appendicitis- revealed focal wall thickening of the cecum and ascending colon suggestive of a cecal mass (Fig. 1). Colonoscopy was not recommended because of the possibility of perforation. Due to the clinical picture and CT scan findings of a possible cecal mass, the patient underwent exploratory surgery. Intraoperatively, gangrene isolated to the cecum with full thickness necrosis was found. No free perforation was noted. Mesenteric pulses were palpable. The patient underwent right hemi-colectomy and had an uneventful postoperative course. Histopathology revealed severe ischemia of the cecum with transmural infarction of the cecal wall and acute peritonitis of the cecal serosa. Proximal (ileal) and distal (colonic) resection margins and appendix showed no evidence of ischemia. The cecal vessels showed no atherosclerosis as well as no evidence of vascular occlusion or vasculitis. Work-up with cardiac echocardiography revealed no focus of embolic disease. The patient was discharged in stable condition one week after surgery. To our knowledge, this is a unique case report of isolated cecal gangrene in a patient with no predisposing cause. Isolated cecal gangrene may present as a diagnostic dilemma owing to its uncommon occurrence and atypical presentation-in this case the radiological impression was that of a cecal mass (was read by four radiologists). Therefore, gastroenterologists should entertain the diagnosis of cecal gangrene in a patient with acute right lower quadrant pain.[figure1]Figure" @default.
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- W2911495616 date "2007-09-01" @default.
- W2911495616 modified "2023-09-23" @default.
- W2911495616 title "Isolated Cecal Infarction with the Radiological Picture of a Mass Lesion in a Patient with an Acute Abdomen and No Obvious Predisposing Factors" @default.
- W2911495616 doi "https://doi.org/10.14309/00000434-200709002-00622" @default.
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