Cecum blind ischemia as an unexpected finding

Abstract

The colon ischemic pathologies have scare clinical features and are difficult to diagnose. We report a case of a with history of arterial hypertension, who presents with abdominal pain of 12 hours in the right iliac fossa without radiation, colic type, of moderate intensity, without other accompanying symptoms. On physical examination the abdomen was soft depressible, painful to deep palpation, signs of Mc Burney, Rovsing and Blumberg were positives. The hemogram reported leukocytosis 12900 with neutrophilia 82.9%. It is diagnosed as acute appendicitis and was planned an appendectomy. The surgeon reported an cecal appendix grade II, good appendicular base, distended bowel loops and ischemia on the anterior face of the cecum, being the cast finding an important one to change the planned surgery to an ileostomy urgent. We consider an important to fact know the evolution patterns of colon ischemia and factors that predict its unfavorable course and mortality.