IntroductionCecal volvulus is an uncommon cause of intestinal obstruction due to an axial twist of the caecum, ascending colon and terminal ileum around the mesenteric pedicle. It is responsible for 1%-1.5 of all intestinal obstructions in adult. The clinical signs may be highly variables and can be responsible of delays in diagnostic and treatment. The delay in diagnosis leads to intestinal necrosis or perforation. The mortality ranges from 10 to 40% depending on the presence of a viable or gangrenous intestine.Presentation of caseA 64 year old woman admitted the emergency department for acute bowel obstruction. Clinical examination found typically acute bowel obstruction signs. Plain radiography showed dilated gas-filled segment of the colon in the left side of abdomen and volvulus of cecum was suspected. Enhanced abdominal CT scan confirmed the diagnosis. Emergency exploratory laparotomy was performed and confirmed the cecal volvulus. A manual untwisting of volvulus and a Caecopexy were performed. The patient subsequently recovered uneventfully and was discharged on postoperative day 3.DiscussionThe management of cecal volvulus requires prompt (emergency) diagnosis and prompt surgical intervention. Any delay in diagnosis may lead to intestinal necrosis or perforation and worsening the prognosis in patients who are generally elderly. Several authors reported a high mortality rate of cecal volvulus due to delay to diagnosis and surgical intervention.ConclusionThe low incidence of this condition needs a high index of suspicion and emergency surgical management. Despite significant progress in medical imaging, the preoperative diagnosis of cecal volvulus is very difficult. As a result, the treatment is often delayed.

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Le volvulus total du grêle complique le mésentère commun incomplet correspond à un arrêt de la rotation à 180° de l'anse intestinale primitive. La racine du mésentère est très courte et l'ensemble de l'intestin grêle se trouve pédiculé sur l'axe artériel mésentérique supérieur. Cette situation est à très haut risque de volvulus du grêle et d'infarctus entero-mésentérique. Le volvulus aigu impose une intervention chirurgicale en urgence; l'imagerie ne doit pas retarder la prise en charge chirurgicale. Le geste chirurgical consiste à la détorsion du volvulus (dans le sens antihoraire), la viabilité de l'intestin appréciée. L'intestin est rangé position de mésentère commun complet: cœcum dans la fosse iliaque gauche. Nous rapportons l'observation d'un patient de 60 ans admis pour volvulus total du grêle sur mésentère commun incomplet, opéré en urgence avec une évolution postopératoire favorable.

This is an open access article distributed under the terms of the CreativeCommons Attribution-Non Commercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractHernia surgery is the most frequent in visceral surgery. The bladder is rarely involved in groin hernia. This is when a diverticulum or a part of the bladder wall is incarcerated within the hernia. This affection is often asymptomatic. The diagnosis is made per-or post-operatively following complications. We report 2 cases of inguinal hernia involving the bladder in which the first case was diagnosed preoperatively whereas the second was diagnosed intraoperatively. ÖzFıtık cerrahisi viseral cerrahide en sık görülenidir. Mesane nadiren kasık fıtığı ile ilişkilidir. Bu, divertikülün veya mesane duvarının bir bölümünün fıtık içinde hapsedilmesidir. Bu durum genellikle asemptomatiktir. Tanı komplikasyonları takiben ameliyat sonrası veya sonrasında yapılır. Bu çalışmada iki kasık mesane fıtığı olgusunu sunuyoruz, mesane ilişkisi birinci vakada preoperatif tanı ile, ikinci vakada intraoperatif olarak teşhis edildi.

Richter's hernia may be defined as an abdominal hernia in which only part of the circumference of the bowel wall is entrapped and strangulated in the hernial orifice. It occurs at various positions with femoral ring being the most common. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. The spontaneous enterocutaneous fistula is a rare complication of inguinal Richter's hernia. We report a case of a 75 year old female patient with enterocutaneous fistula which occurred spontaneously in the right inguinal region. Abdominal computed tomography scan confirmed the diagnosis of enterocutaneous fistula. We performed a right celiotomy with resection and primary anastomosis of the fistulous bowel. Patient recovered uneventfully without any complications or recurrence.