Cecal Volvulus in Malrotation at 41years

Abstract

Cecal volvulus is rare, and its preoperative diagnosis poses a challenge. Because of its variable clinical features, the ultimate diagnosis of cecal volvulus is determined during surgery. We aim to demonstrate the rarity of cecal volvulus, the challenge in preoperative diagnosis of cecal volvulus, and the use of surgery in both diagnosis and treatment. We herein present a case of ischemic cecal volvulus in a 41-year-old man who presented within 5 hours of onset of symptoms of abdominal pain, vomiting, and lower abdominal distension. He had not passed flatus or opened bowels for a day. The available abdominal radiographs did not reveal preoperative cecal volvulus. An emergency laparotomy was performed, and it showed ischemic anticlockwise cecal volvulus that was managed by right hemicolectomy plus ileo-transverse primary anastomosis and transverse colopexy. The post-operative recovery and follow-up were uneventful.

Keywords

• cecal volvulus
• cecopexy
• transverse colopexy