Intestinal Volvulus Following Laparoscopic Surgery: A Literature Review and Case Report

Abstract

Since its introduction in the early 1990s, the laparoscopic cholecystectomy has become the standard surgical intervention for cholelithiasis. The laparoscopic technique is being used in an increasing number of abdominal procedures. Intestinal volvulus is a rare complication of laparoscopic procedures, such as the laparoscopic cholecystectomy. A review of the literature revealed 12 reports of this complication occurring without a clear cause. Etiologic factors that have been postulated include congenital malrotation, previous surgery, and intraoperative factors, such as pneumoperitoneum, mobilization of the bowel, and patient position. In this paper, we review the literature for this rare complication and report on a case of cecal bascule (a type of cecal volvulus) occurring following the laparoscopic cholecystectomy. Of the 12 prior reports of intestinal volvulus following laparoscopic procedures, 8 of these followed the laparoscopic cholecystectomy, of which two were cecal volvulae. This is the first reported case of a cecal bascule occurring following the laparoscopic cholecystectomy.

Cecal bascule in a child: an unusual cause of postoperative bowel obstruction

“…Despite this common anatomical predisposition, the rare nature of a cecal bascule is caused by the need for ongoing bowel distension, such as in the case of a postoperative ileus. Recent literature has described cecal bascule and volvulus after laparoscopic surgery, and it has been hypothesized that pneumoperitoneum in combination with a mobile cecum can establish a setting ripe for cecal movement [7][8][9]. Changes in patient position (ie, from reverse Trendelenburg position to a horizontal plane) may allow a mobile cecum to flip upward, obstructing the ascending colon and resulting in cecal bascule.…”

Volvulus du grêle sur mésentère commun incomplet une redoutable complication rare chez l’adulte: à propos de 1 cas

“…Les complications chroniques résultent des sténoses duodénales incomplètes ou de volvulus chroniques du grêle avec insuffisance artérielle mésentérique. Le diagnostic de volvulus total du grêle peut se faire dans des circonstances très variées:en urgence devant un tableau d'occlusion intestinale aiguë, voire un état de choc [6] pouvant conduire au décès, devant un tableau de douleurs abdominales répétées plus ou moins associées à des troubles du transit; plus rarement, au décours d'une chirurgie laparoscopique, comme cela a été décrit après une cholécystectomie [7–11], une appendicectomie [12, 13] ou une chirurgie de l'obésité.…”

Caecal volvulus: a consequence of acute cholecystitis

“…An additional factor is usually responsible for the development of caecal volvulus, and high fibre intake, chronic constipation, adynamic ileus, pregnancy, adhesions from previous surgery and distal colonic obstruction are known factors associated with an increased risk of caecal volvulus 2 3 5. Recently, cases of caecal volvulus following laparoscopic cholecystectomy6 laparoscopic nephrectomy7 and laparoscopic appendicectomy8 have been reported.…”