Localized Ulceration of the Caecum due to Microcirculatory Thrombosis: A New Concept of Non‐Specific Ulceration of the Caecum

Abstract

Uncommon lesions of the caecum are of interest because of the diagnostic and therapeutic difficulties associated with them. This paper presents the case reports of three patients with such a lesion. The pathology found was typical of that seen in the condition formerly described as “non‐specific ulceration of the caecum”, but the additional finding of micro‐circulatory thrombosis suggests the probable pathogenesis and leads to a new concept of the lesion, thus allowing a more definitive name to be applied to it. A review of the literature is presented, the natural history discussed, and a plan of management formulated. Because of the similarity of the clinical features to those of acute appendicitis, the correct diagnosis is rarely made before operation, but even at operation differentiation from more serious pathology may be difficult. The treatment of choice is immediate wide resection.

A Case Report of Idiopathic Cecal Ulcer Mimicking Cecal Cancer

“…Many theories have been proposed to explain ulcer formation: a causative role of medications [4,5], stasis of the colonic contents in the cecum, an analogy between cecal and gastric ulcers [6], sequelae of cecal diverticulitis [7][8][9], and ischemia [10,11]. The pathological demonstration of vascular thrombosis in or adjacent to the ulcer, as in our case, may support the hypothesis of localized ischemia [12].…”

Solitary cecal ulcer - case report and treatment options according to literature review

“…According to some authors, a possible etiology of SCU is limited ischemia, caused by vasculitis and/or micro-embolization of the terminal branches of the colon nutritional arteries [9,10]. The most mentioned cause of SCU is NSAID drugs [11], but we found only a few cases of SCU in patients on NSAID therapy.…”