Caecal volvulus associated with complex small bowel malrotation and congenital bands: A case report and literature review

Abstract

Caecal volvulus is an uncommon condition and represents only 10% of all colonic volvulus. The mechanism is due to hypermobile cecum twisting around it is own mesentery. A 40-year-old female who was previously fit and well-attended hospital with 2 days history of intermittent abdominal pain, mild distention and constipation. X-rays showed twisted and dilated loops of bowel with right hepato-diaphragmatic bowel loops entrapment. A computed tomography scan was the only confirmatory test of caecal volvulus with intermittent bowel symptoms. Emergency laparotomy revealed complex intraoperative bowel loops malrotation with congenital bands and abnormal position of Duodeno-Jejenal flexure. Open right hemicolectomy was the operation of choice for this complex case. Caecal volvulus must be considered as one of the important differential diagnosis of acute abdomen during initial assessment of patients with intermittent bowel symptoms in emergency department in order to avoid any therapeutic delay.

Reversed midgut rotation revealed by cecal volvulus in the elderly: A case report

“…In our case, clinical manifestation was a life-threatening condition as in newborns: cecal volvulus. This revealing circumstance was mentioned for other types of intestinal malrotation: intestinal malrotation [ 7 ] and complex small bowel malrotation and congenital peritoneal bands [ 8 ]. Unlike our patient, cecal volvulus occurred in female gender and younger cases accounting for 1 % of large bowel obstructions [ 9 ].…”

Cecal volvulus: a rare entity of acute bowel obstruction

“…In untreated patients, they can progress to intestinal strangulation, ischemia, necrosis and perforation. 5 The initial approach is through the radiography of the abdomen finding dilation of the cecum (98-100%), airfluid levels (72-88%), intestinal dilation (42-55%), absence of gas in the distal colon (82%) and the presence of intestinal loops lateral to the cecum. Simple abdominal radiography has a sensitivity of 75% and specificity of 52%.…”