Citation

Feng CY, Liang JT, Lin MT, Lee WJ, Chang KJ. Journal of Surgical Association Republic of China 1998; 31(1): 41-45.

Copyright

(Copyright © 1998)

DOI

unavailable

PMID

unavailable

Abstract

Cecal volvulus is an uncommon disease accounting for about 1% of all intestinal obstruction and 20 to 40% of all colonic volvulus. Its incidence ranges from 3 to 7 per million per year. The most common symptoms of cecal volvulus are abdominal pain, vomiting, abdominal distension, and constipation. The most reliable diagnostic procedure is the barium enema. The rotation of cecal volvulus is usually clockwise and gangrenous change occurs when the twist is 360 degrees. Resection of the gangrenous bowel is mandatory. However, the treatment of choice for cecal volvulus without gangrene is diverse and still controversial. Herein we report an unusual case of a 75-year-old female patient with volvulus of the cecum. Clinically, the patient presented with abdominal distention, abdominal pain, and vomiting. Her past-history revealed a corrosive injury of esophagus due to a suicide attempt. Tracheostomy and gastrostomy had been performed for 3 years. Standing abdominal film, barium enema study of lower gastrointestinal tract, small bowel series with barium meal through gastrostomy, and abdominal CT scan with contrast showed distended bowel at ascending colon, which was displaced to left upper abdomen. Operative findings were counterclockwise volvulus of the cecum to 540°, without gangrenous change of bowel, a very rare condition. Right hemicolectomy and end-to-end anastomosis were performed, and after surgery the patient had a satisfactory recovery. We also review the literature regarding volvulus of the cecum to discuss the predisposing factors, clinical features, diagnosis and treatment.

Language: en

Keywords

abdominal distension; abdominal pain; abdominal radiography; aged; article; barium enema; barium meal; case report; cecum; Cecum; colon volvulus; computer assisted tomography; end to end anastomosis; esophagus injury; female; hemicolectomy; human; suicide attempt; Volvulus; vomiting