Idiopathic cecal ulcer. Diagnosis by colonoscopy followed by nonoperative management

Digestive Diseases and Sciences
C R Blundell, D L Earnest

Abstract

Idiopathic ulcer of the cecum has been considered a rare condition requiring surgical treatment because of a high incidence of complications, including bowel perforation. Cecal ulcerations are usually diagnosed at the time of surgery for presumed appendicitis or peritonitis of unknown origin. Preoperative diagnosis of cecal ulcer by barium enema has been unreliable and previous literature cites only one case diagnosed by colonoscopy. We describe four cases in which the diagnosis was made at colonoscopy. Three of our four patients were treated conservatively and did not require laparotomy. Idiopathic cecal ulcer should be considered in the differential diagnosis of lower gastrointestinal hemorrhage as well as atypical appendicitis. If the diagnosis of cecal ulcer is made by colonoscopy in a patient without evidence of an acute abdomen, conservative management may be followed by complete healing, avoiding unnecessary surgery.

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Citations

Apr 1, 1994·Digestive Diseases and Sciences·C A Rubio, S Nydahl
Mar 1, 1991·The Japanese Journal of Surgery·M HaraguchiK Sugimachi
Oct 1, 1985·Diseases of the Colon and Rectum·R W ShallmanR Sautter
Jun 10, 2010·International Journal of Colorectal Disease·Sung Jae ShinWon Ho Kim
May 10, 2008·Digestive Diseases and Sciences·Jae Myung ChaKyo Young Kim
Jan 27, 2016·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Dong Han YeomHaak Cheoul Kim
May 21, 2010·Journal of Clinical Gastroenterology·Neil NagariaSushil Ahlawat
Mar 20, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J OngK-W Eu
Sep 23, 2016·Gut·Nan Wu, John Saul Freiman

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