Document Detail


"Cecal gangrene": a rare cause of right-sided inferior abdominal quadrant pain, fever, and leukocytosis.
MedLine Citation:
PMID:  15290557     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
We report on a 58-year-old man with known diabetes, congestive heart failure, and need for chronic hemodialysis presenting with right lower abdominal quadrant pain, fever, and leukocytosis. Although initial clinical findings were highly suggestive of acute appendicitis, CT revealed marked circumferential wall thickening of the cecum, which was interpreted as cecal infarction by the radiologist. Intraoperatively, cecal necrosis was confirmed, but the ileocecal valve and, especially, the appendix showed no ischemia. No vascular occlusions were found. Histopathologic analysis of the resected cecum demonstrated isolated transmural cecal necrosis with marked infiltration of the cecal wall by numerous bacteria and neutrophils. We present the CT features and histopathologic findings of isolated cecal gangrene, review the pathogenesis of occlusive and nonocclusive cecal ischemia or infarction, and discuss the role of bacterial superinfection as a potential cofactor in the pathogenesis of isolated cecal necrosis which should be included in the differential diagnosis of right-sided inferior abdominal quadrant pain.
Authors:
Walter Wiesner; Koenraad J Mortelé; Jonathan N Glickman; Pablo R Ros
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Publication Detail:
Type:  Journal Article     Date:  2002-11-05
Journal Detail:
Title:  Emergency radiology     Volume:  9     ISSN:  1070-3004     ISO Abbreviation:  Emerg Radiol     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2004-08-03     Completed Date:  2005-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431227     Medline TA:  Emerg Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  292-5     Citation Subset:  -    
Affiliation:
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. wwiesner @uhbs.ch
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