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Case Reports
. 2025 Sep 23;17(9):e93052.
doi: 10.7759/cureus.93052. eCollection 2025 Sep.

Isolated Cecal Pole Ischaemia: A Rare and Underrecognised Variant of Acute Mesenteric Ischaemia Mimicking Acute Appendicitis

Nay C Lin  1 , Maria Iqbal  1 , Ali A Warsi  1
Affiliations
Case Reports

Isolated Cecal Pole Ischaemia: A Rare and Underrecognised Variant of Acute Mesenteric Ischaemia Mimicking Acute Appendicitis

Nay C Lin et al. Cureus. .

Abstract

Isolated caecal pole ischaemia is a rare and often underrecognised variant of acute mesenteric ischaemia (AMI) that can closely mimic the clinical presentation of acute appendicitis. This case report describes a 78-year-old man who presented with right iliac fossa pain and vomiting. Initial investigations suggested acute appendicitis; however, contrast-enhanced computed tomography (CT) revealed an ischaemic caecum and an occluded superior mesenteric artery (SMA). Despite conservative management, the patient's condition deteriorated, and exploratory laparotomy revealed a gangrenous cecal pole, prompting ileocecal resection. Histopathology confirmed ischaemic necrosis, and the patient recovered well postoperatively. This case highlights the diagnostic challenges associated with isolated caecal pole ischaemia and underscores the importance of early imaging and surgical intervention, especially in patients with significant vascular risk factors.

Keywords: appendicitis mimic; caecal ischaemia; ischemic colitis; right iliac fossa (rif) pain; vascular risk factors.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. N/A issued approval n/a. N/a. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CECT abdomen and pelvis. The arrow highlights the cecal wall, which appears thickened and hypoenhancing with surrounding fat stranding, consistent with ischaemia
CECT: Contrast Enhanced Computed Tomography
Figure 2
Figure 2. CECT abdomen and pelvis. The arrow indicates the proximal superior mesenteric artery, showing near-complete occlusion with a calcified, narrowed lumen
CECT: Contrast Enhanced Computed Tomography
See this image and copyright information in PMC

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