Cecal bascule with secondary gastric outlet obstruction in addition to a large bowel closed obstruction: A case report

Abstract

We present a case of cecal bascule in a 60-year-old woman with abdominal pain and vomiting. Imaging tests revealed a cecal bascule causing mechanic obstruction of the stomach. Besides a small bowel dilatation was not seen, the distended cecum was extrinsically obstructing the antrum and therefore, the gastric outlet. Cecal bascule is a form of cecal volvulus without the axial twisted component. The cecum folds anterior or anteromedially on itself and, because of a valve mechanism, becomes distended. The pressure increases and it begins to compromise arterial blood flow so life-threatening complications, such as bowel ischemia and infarction can occur. Prompt diagnosis is therefore crucial and plain radiographs and computed tomography are the preferred imaging techniques for this purpose.

Keywords

• Intestinal volvulus
• Acute abdomen
• Intestinal obstruction
• Multidetector computed tomography
• Diagnostic X-ray