Cecal Necrosis Due to Ischemic Colitis Mimicking an Abscess on Sonography

Isolated cecal necrosis is a rare form of acute ischemic colitis and a rare cause of surgical abdomen. Behçet's disease is a multisystemic autoimmune condition which can induce vasculitis. This can result in cecal necrosis while disease involves colon vessels. We describe a patient with complicated Behçet's disease and ischemic colitis admitted to our hospital. Patient was a 62-year-old female with more accompanying diseases. Histopathologic findings confirmed the diagnosis of ischemic colitis and regarding patient's vision problem and skin lesions, rheumatologic tests were performed which were positive for HLAB5 and HLAB51 suggestive of Behçet's disease; the patient was improved with surgery. Abdominal pain can indicate a disease with vascular involvement like Behçet's disease, especially in the presence of other clinical findings suggestive of the disease including blurred vision and skin lesions. An abdominal computerized tomography (CT) scan is very diagnostic in the same patients.

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“…Cecal necrosis often occurs in elderly patients [12]. Only one of 18 patients of Abel et al [13] was under 50 years old.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Vasculitis Patched Necrosis of Cecum due to Behçet’s Disease

Shahverdi

Morshedi

Oraei-Abbasian

et al. 2017

Case Reports in Surgery

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“…CT-scan images of caecal wall thickening are often misinterpretated, like in our case, as a caecal neoplasm (5). On sonography, caecal necrosis has also been described mimicking an abscess, of presumable appendiceal origin (6).…”

Section: Discussionmentioning

confidence: 93%

Ischaemic Caecal Necrosis

Ruiz-Tovar¹,

Gamallo²

2008

Acta Chirurgica Belgica

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Isolated ischaemic caecal necrosis is an unusual event. Because right colon location is less frequent than left one, it may not be considered in the differential diagnosis of right lower quadrant pain. With the typical symptoms (right-sided abdominal pain and tenderness), patients are suspected of having either appendicitis or caecal carcinoma. CT-scan images of caecal wall thickening are often misinterpretated as acecal neoplasm or abscess. We present a case of isolated ischaemic caecal necrosis misinterpretated as a caecal neoplasm.

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“…El diagnóstico de la isquemia intestinal de colon es difícil, por lo cual deben considerarse los antecedentes. Uno de los trastornos que más se asemejan a la isquemia cecal (la forma más común de lesión isquemia gastrointestinal) es la apendicitis, cuyo diagnóstico se establece hasta en 36% de manera transoperatoria 8,9 .…”

Section: Discussionunclassified

“…Ante este índice diagnóstico, los estudios de imagen muestran pocos hallazgos: adelgazamiento de la pared del colon (abscesos) y flujo vascular reducido; más aún, Ripolles, et al, describieron que la alteración de la grasa pericólica puede ser el único hallazgo 8,9 .…”

Section: Discussionunclassified

Necrosis colónica secundaria. Informe de caso

Aburto-Fernández¹,

Araujo-López²,

García-Godoy³

et al. 2019

CIRU

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La lesión vascular colónica secundaria a la sobredosis de verapamilo, es mediada por radicales libres, formando microtrombos vasculares y generación de endotoxinas, siendo un diagnostico difícil. Caso Clínico: Femenino de 27 años, ingresa con abdomen agudo de 4 días posteriores a un evento remitido de intento suicida por sobredosis de verapamilo, interviniéndose quirúrgicamente donde se halla necrosis colónica transmural derecha, realizando hemicolectomía derecha con ileostomía terminal. Conclusiones: Reconocer y tratar de forma adecuada un abdomen agudo, no siempre se suele llegar a un adecuado diagnostico, por lo cual una minuciosa anamnesis lograría concluirlo.

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Cecal Necrosis Due to Ischemic Colitis Mimicking an Abscess on Sonography

Cited by 7 publications

References 14 publications

A Rare Case of Vasculitis Patched Necrosis of Cecum due to Behçet’s Disease

A Rare Case of Vasculitis Patched Necrosis of Cecum due to Behçet’s Disease

Ischaemic Caecal Necrosis

Necrosis colónica secundaria. Informe de caso

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