Cecal volvulus in cerebral palsy: Report of a case

Abstract

A rare case of cecal volvulus in cerebral palsy that was preoperatively diagnosed and surgically treated without complications is herein reported. A 45-year old man, who had been treated for cerebral palsy as a result of a neonatal cerebral hemorrhage, was admitted to our hospital because of abdominal pain and vomiting. A plain abdominal X-ray film showed evidence of a huge quantity of gas in the left abdomen. Using a gastrographin enema from the colonoscope, an obstruction of the ascending colon was revealed with tapering of the lumen. A computed tomography scan showed a grossly dilated air-distended bowel in the left abdomen and soft tissue with internal architecture containing swirling strands of soft tissue and fat attenuation. An emergency laparotomy was performed. During the laparotomy the ileocecal region, which was unfixed at the retroperitoneum, was found to be twisted counterclockwise by 360 degrees around the mesentery with the terminal ileum, thus resulting in a diagnosis of cecal volvulus. We therefore conducted an ileocecal resection. Cecal volvulus is an uncommon form of intestinal obstruction with a high mortality rate and may present considerable difficulty in diagnosis. Although cecal volvulus is rare as a cause of intestinal obstruction, it should be included in the differential diagnosis of bowel obstruction in cerebral palsy.

The Lethal Twist A Story of Unspoken Pain: Small Intestinal Volvulus in Cerebral Palsy.

“… 3 , 4 While gastric and colonic volvulus have been more frequently reported in cerebral palsy patients, small intestinal volvulus is a life-threatening, albeit rare condition that needs to be recognized quickly, and treated urgently in this patient population. 5 , 6 …”

Cecal volvulus associated with mobile cecum in Cornelia de Lange syndrome: Report of a case

“…Cecal volvulus is a very rare cause of intestinal obstruction in all ages and is often seen in patients with a neurological disorder [1]. It is quite difficult to diagnose cecal volvulus in its early stage.…”

“…Cecal volvulus is a rare cause of intestinal obstruction and is often seen in neurologically handicapped patients [1]. Cecal volvulus is not easy to diagnose in many cases and severe necrosis of the affected portion of the intestine may result in the patient's death.…”

Recurrent Bowel Obstruction Caused by Cecal Volvulus: A Case Report

“…Although some characteristics have been reported, the diagnosis of CV by abdominal radiography alone is challenging. Reportedly, a barium enema could reveal the bird beak sign, which is a smooth tapering cutoff at the efferent limb of the obstruction 10 . A barium enema can only be performed if the patient is stable because of the risk of perforation during the enema.…”