Kohga Atsushi, Yajima Kiyoshige, Okumura Takuya, Yamashita Kimihiro, Isogaki Jun, Suzuki Kenji, Komiyama Akira, Kawabe Akihiro
Division of Surgery Fujinomiya City General Hospital, Fujinomiya, Shizuoka Prefecture 418-0076, Japan.
Division of Pathology Fujinomiya City General Hospital, Fujinomiya, Shizuoka Prefecture 418-0076, Japan.
Medicina (Kaunas). 2019 Jan 10;55(1):9. doi: 10.3390/medicina55010009.
Isolated cecal necrosis (ICN) is a rare condition which is developed under decreased mesenteric perfusion. Only a few dozen cases of ICN have been reported previously. The patient was a 59-year-old male with a previous history of atrial fibrillation. He presented to our emergency room with the chief complaint of lower abdominal pain. Computed tomography imaging revealed a dilated cecum and presence of free air. With a preoperative diagnosis of perforation of the cecum; an urgent surgery was conducted. Intraoperative findings revealed an ischemic change of the cecum and a laparoscopic-assisted ileocecal resection was performed. The pathological findings showed transmural ischemic change on the anti-mesenteric side of the cecum, and the diagnosis of ICN was achieved. Preoperative diagnosis of ICN is difficult because of its non-specific radiological features. In patients with right lower abdominal pain, ICN should be considered as a differential diagnosis especially if the patient has a comorbidity causing hypotension attack.
孤立性盲肠坏死（ICN）是一种在肠系膜灌注减少情况下发生的罕见病症。此前仅报道过几十例ICN病例。该患者为一名59岁男性，有房颤病史。他因下腹部疼痛为主诉前来我院急诊室就诊。计算机断层扫描成像显示盲肠扩张且存在游离气体。术前诊断为盲肠穿孔；遂进行了紧急手术。术中发现盲肠有缺血性改变，并实施了腹腔镜辅助回盲部切除术。病理检查结果显示盲肠对系膜侧有透壁性缺血改变，从而确诊为ICN。由于ICN的放射学特征不具特异性，术前诊断较为困难。对于右下腹痛患者，尤其是伴有导致低血压发作的合并症患者，应将ICN作为鉴别诊断之一。
