2024 Volume 44 Issue 7 Pages 903-906
The patient was a 77-year-old male with a medical history of diabetes, hypertension, and congestive heart failure. In X month of 2022, he presented to our emergency department with the chief complaint of right lower abdominal pain. Abdominal contrast-enhanced CT revealed necrosis of the ileocecal region, and an emergency surgery was performed. Intraoperative findings revealed localized necrosis in the terminal ileum, cecum and part of the ascending colon, but no discoloration or necrosis was observed in other parts of the small or large intestine. We performed ileocecal resection and created a double-barreled colostomy at the ascending colon and ileum. Postoperative histopathology did not reveal any obvious thrombi or vasculitis, and since the necrosis was limited to the ileocecal area, it was thought that vasospasm had occurred only in the cecal branch. Since no acute disease that could cause spasm could be identified and the necrosis was localized, this condition also differed from non-occlusive intestinal ischemia and could be considered as necrotizing ischemic enteritis caused by idiopathic vasospasm without the involvement of intestinal factors.
