Surgical diagnosis of idiopathic cecal ulcer: presentation of two clinical cases

and pseudopolyps with edematous and hyperemic mucosa. Moreover, there was a stenosis of the ileocecal valve. The histological examination of multiple biopsies showed the presence of granulation tissue, glandular atrophy, and aspecific chronic inflammation with no displastic or neoplastic elements. The specimens were consistent with the initial IBD, even though a malignant disease could not be excluded. Due to the ongoing symptoms and the high suspect of a large bowel cancer, the patient underwent a surgical intervention. At the surgical exploration, a substenotic mass involving the cecum and the ileo-cecal valve was detected. There were no signs of metastatic disease. A right hemicolectomy was performed. The post-operative course was uneventful. The operative specimen showed the presence of an ulcerated lesion with colonic wall thickening and granulation tissue associated with inflammatory infiltrate in the lamina propria. The findings were consistent with solitary ulcer of the ileo-cecal valve.