Cecal bascule: a systematic review of the literature

Abstract

Cecal bascule is a rare clinical entity, which is mostly encountered in patients with peritoneal adhesions, mobile cecum, bowel dysfunction, and cecal displacement. In patients with recurrent or persistent abdominal pain and distension, cecal bascule should be considered. The majority of these patients require surgical management.

An Unlikely Cause of Abdominal Pain

“…Laboratory results are neither sensitive nor specific, but practitioners typically find a leukocytosis and potentially hyperkalemia, azotemia or anemia in more severe cases. 10 In our patient the lack of these findings likely portended to her having presented early in the disease course, and her hypokalemia and alkalosis resulted from her being relatively volume depleted -- not from vomiting as is the usual case, but from being unable to use her PEG-tube as it was causing her discomfort.…”

“…It can take numerous forms including colectomy, cecopexy, cecopexy supplemented by cecostomy, or cecectomy. 10 …”

A Rare Pathological Couplet of Colocolic Intussusception Plus Cecal Bascule in a Young Adult: A Case Report

“…Cecal volvulus is uncommon, accounting for about 15% of all cases of colonic volvulus. These can be classified into three types: the axial-torsion type where cecal rotation is in the axial plane; the loop-type, where there are both cecal rotation and inversion; or the bascule-type [ 4 - 5 ]. With a peak incidence of 55 years, cecal bascule is a rare occurrence with a slightly higher male predominance [ 5 ].…”

“…These can be classified into three types: the axial-torsion type where cecal rotation is in the axial plane; the loop-type, where there are both cecal rotation and inversion; or the bascule-type [ 4 - 5 ]. With a peak incidence of 55 years, cecal bascule is a rare occurrence with a slightly higher male predominance [ 5 ]. A cecal bascule, which represents about 10% of cecal volvuli, is characterized by a mispositioned cecum being folded in a cephalad (most common) or caudad direction with no torsion of its mesentery [ 4 ].…”

“…A cecal bascule, which represents about 10% of cecal volvuli, is characterized by a mispositioned cecum being folded in a cephalad (most common) or caudad direction with no torsion of its mesentery [ 4 ]. Its incidence is 2.8-7.1 per million people per year and several etiologies have been suggested, including congenital adhesions or distal colonic obstruction [ 5 - 7 ]. A cecal bascule can clinically present with such signs as cecal displacement to the upper or central abdomen, ileocecal valve displacement to the right upper quadrant, a transition zone between the cecum and ascending colon, and as reactive perihepatic free fluid [ 7 - 8 ].…”