A Case of Isolated Cecal Necrosis Treated with Laparoscopic Resection

Abstract

An 82-year-old man presented to our institution with a one-day history of abdominal pain and bloody stool. The abdomen was flat and right. Tenderness with peritoneal signs was present in all quadrants. Blood test findings revealed elevations in the white blood cell count and CRP. A plain CT scan of the abdomen showed significant wall thickening from the ileocecal area to the ascending colon with fat density elevation sign and free air. We diagnosed the case as colon perforation and performed emergency laparoscopic surgery. Observation of the peritoneal cavity revealed ischemia and gangrene of the cecum. We performed laparoscopic ileocecal resection on the same day. The postoperative course was uneventful. Isolated cecal necrosis appeared to be associated with the patient's history of arteriosclerosis. Isolated cecal necrosis should be considered in diagnosing right lower abdominal quadrant pain.