Gangrenous ischemic colitis localized to the cecum: a case report

• Published in: Surgical case reports Vol. 9; no. 1; p. 9
• Main Authors: Tateno, Kohei, Motegi, Yoko, Ogawa, Hiroomi, Suga, Kunihiko, Okada, Takuhisa, Osone, Katsuya, Katoh, Ryuji, Ubukata, Yasunari, Saito, Hideyuki, Hara, Keigo, Sakai, Makoto, Ogata, Kyoichi, Sohda, Makoto, Murakami, Chiaki, Shirabe, Ken, Saeki, Hiroshi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 23.01.2023; Springer Nature B.V; SpringerOpen
• Subjects: Case Report; Case reports; Cecal necrosis; Diabetic nephropathy; Gangrene; Hemodialysis; Inflammatory bowel disease; Ischemic colitis; Medicine; Medicine & Public Health; Surgery; Hemodialysis; Cecal necrosis; Ischemic colitis
• ISSN: 2198-7793; 2198-7793
• DOI: 10.1186/s40792-023-01587-x

Background Ischemic colitis affects the left colon in elderly individuals and localization on the right side, especially in the cecum, is rare. We report a case of gangrenous ischemic colitis localized in the cecum of a patient undergoing hemodialysis. Case presentation A 73-year-old man had been undergoing hemodialysis for chronic renal failure caused by diabetic nephropathy. He experienced frequent vomiting, diarrhea, and abdominal pain. Contrast-enhanced computed tomography revealed thickening of the cecal wall, poor enhancement, dilation of the cecum, and intrahepatic portal emphysema. No obvious abnormal findings were observed in the appendix. The patient was diagnosed with cecal necrosis and ileocecal resection was performed. Histopathological examination revealed gangrenous ischemic colitis of the cecum. He was discharged 12 days after surgery without postoperative complications. Conclusion It is important to consider the possibility of ischemic colitis of the right colon in the event of renal failure requiring dialysis, to ensure that opportunities for surgical intervention are not missed.