Partial Cecum Necrosis as a Rare Cause of Acute Abdominal Pain in an Elderly Patient.

ABSTRACT

Partial necrosis of the cecum is a rare form of ischemic colitis with unknown etiology. A 68-year female patient was admitted due to a severe pain in the right lower quadrant of the abdomen for one week. One month ago, she had coronary artery bypass graft surgery with carotid endarterectomy. During physical examination, tenderness and rebound tenderness at the right lower quadrant were detected. Computed tomography showed a 7-mm tubular structure extending from the back of the cecum to the lower border of the liver. Laparoscopic appendectomy was planned with a preoperative diagnosis of acute appendicitis. During laparoscopy, a 3x3 cm necrotic area was noticed on the lateral wall of the cecum. After conversion to open surgery, partial cecum resection and ileocolostomy with appendectomy were performed. She was discharged on the 6th postoperative day, uneventfully. An isolated non-occlusive mesenteric ischemic event should be thought as a differential diagnosis in elderly patients who have right lower quadrant pain with atypical presentation, if there is chronic cardiac or renal failure.