Eyvaz Kemal, Sıkar Hasan Ediz, Gökçeimam Mehmet, Küçük Hasan Fehmi, Kurt Necmi
Department of General Surgery, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
Department of General Surgery, University of Health Sciences, Kartal Training and Research Hospital, İstanbul, Turkey.
Turk J Surg. 2018 Sep 14;36(3):317-320. doi: 10.5152/turkjsurg.2018.1334. eCollection 2020 Sep.
We aimed to present a 76-year-old female patient with cecal necrosis, which is a rare cause of acute abdomen in elderly women and a variant of ischemic colitis.
The patient was admitted to hospital with abdominal pain, anorexia and nausea. Physical examination, laboratory parameters and abdominal computed tomography revealed acute abdomen. We operated the patient with below umbilical midline incision. Although the pain localized to the right lower quadrant made us consider acute appendicitis as first diagnosis, other pathologies were also kept in mind for differential diagnosis.
Non-occlusive cecal necrosis was determined, and terminal ileum and cecum resection and Meckel’s diverticulum excision were performed. Arterial pulsation was palpated, and no sign of thrombus was found.
Isolated necrosis of the cecum may be due to multiple reasons. Especially in elderly female patients with predisposing factors like hypotension, sepsis, shock, drug use, vasculitis, and hypercoagulability, cecum necrosis should be kept in mind.
我们旨在介绍一名76岁的女性盲肠坏死患者，盲肠坏死是老年女性急性腹痛的罕见原因，也是缺血性结肠炎的一种变体。
该患者因腹痛、厌食和恶心入院。体格检查、实验室指标及腹部计算机断层扫描显示为急性腹痛。我们采用脐下中线切口对患者进行手术。尽管局限于右下腹的疼痛使我们最初考虑诊断为急性阑尾炎，但在鉴别诊断时也考虑了其他病变。
确诊为非闭塞性盲肠坏死，并进行了回肠末端和盲肠切除术以及梅克尔憩室切除术。可触及动脉搏动，未发现血栓迹象。
孤立性盲肠坏死可能由多种原因引起。尤其是在有低血压、败血症、休克、药物使用、血管炎和高凝状态等易感因素的老年女性患者中，应考虑到盲肠坏死的可能。
