Primary Cecal Pathologies Presenting as Acute Abdomen and Critical Appraisal of Their Current Management Strategies
Conditions: Acute Abdomen, Emergency Surgery, Laparotomy, Amoebic Colitis, Diverticulitis of Caecum, Typhlitis
Sponsor: Jawaharlal Nehru Medical College

Cover Page 
Title: Primary Cecal Pathologies Presenting as Acute Abdomen and Critical Appraisal of Their 
Current Management Strategies in Emergency Settings 
NCT Identifier Number: Not assigned 
Document Date: 01/01/2016 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

AIMS & OBJECTIVES 
The objective of this study was to identify the reported causes of cecal pathology presenting as 
acute abdomen in medical literature and the various causes presenting in our setting, to identify 
the pattern of common pathologies in our setup, to discuss morbidity and mortality associated 
with cecal pathologies and to critically analyse the various management modalities commonly 
employed for cecal pathologies presenting as acute abdomen. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

MATERIALS & METHODS 
This is a retrospective analysis of the prospectively collected data of patients admitted to our 
unit in last 10 years for acute abdomen, in whom cecal pathology was identified as the prime 
culprit. 
Inclusion Criteria: All adult patients presenting in emergency department with acute abdomen 
were included in study in whom cecal pathology as the cause of acute abdomen was suspected 
clinically and/or on imaging and further confirmed per-operatively and/or on histopathological 
examination (HPE) or on imaging. Patients identified with primarily a cecal pathology who 
had acute pain abdomen as the initial symptom but who didn’t presented immediately due to 
various reasons1 were also included in the study as it is a well-documented fact that patients in 
developing countries like ours, especially those who live in rural areas or who are illiterate 
often resort to indigenous methods of treatment or take symptomatic treatment from local 
practitioners before presenting to a tertiary centre like ours for definitive treatment. Also, only 
those patients who were operated within 24 hours of index admission in the emergency 
operation theatre (EOT) by a registrar or faculty member itself after initial resuscitation were 
included in the study. 
Exclusion Criteria: Patients with sub-acute, intermittent or chronic pain; when predominant 
symptoms were attributable to some other cause even with concomitant presence of a cecal 
pathology; when predominant pathology was not cecal and patients with cecal pathology 
operated as an elective case were excluded from our study. Thus patients diagnosed to be 
having appendiceal stump blowout, perforation of base of appendix, ileocecal tuberculosis or 
intussusception were not included. 

We analysed this data of patients admitted to our unit for acute abdomen in whom cecal 
pathology was the primary cause for the various management options employed and the final 
outcome of these patients.