Abstract

Non-occlusive acute colonic ischemia is frequently seen in elderly population due to low blood flow and clinically is presented with right lower quadrant abdominal pain mimicking acute appendicitis. Following physical examination; blood tests, radiologic examinations and endoscopic procedures are helpful for diagnosis. Many operative techniques were reported although right hemicolectomy with anastomosis is the most prefered surgical procedure.

A 58 year-old male who had appendectomy 4 months ago, presented with right lower quadrant abdominal pain and rectal bleeding. The patient had been diagnosed with chronic renal failure for 5 years and had been on hemodialysis programme for three times a week. Following physical examination, colonoscopy was performed and patient was diagnosed with cecal necrosis. Patient underwent emergent operation for right hemicolectomy with anastomosis. On postoperative day 9, patient was discharged without any postoperative complications.

Although isolated cecal necrosis is a rare condition we should consider this pathology in patients with chronic heart disease, chronic renal failure and on routine hemodialysis programme.