Volvulus of the Cecum and Right Colon

Haskin, Pamela H.

doi:10.1001/jama.1981.03310480049032

Cited by 20 publications

(16 citation statements)

References 5 publications

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“…In our series, plain radiographs were diagnostic in the majority of cases (71%), and contrast enema was only required in 11% of our patients. The increased sensitivity of the plain abdominal film in our series (in comparison to older studies) may be a reflection of increasing awareness of this condition and its characteristic "kidney-bean" or "ace-ofspades" appearance [25].…”

Section: Discussionmentioning

confidence: 44%

Cecal volvulus: outcome of management by celiotomy

Grossmann

Johnson

Enger

et al. 2000

Techniques in Coloproctology

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This study was undertaken to evaluate the care of patients with cecal volvulus recently treated in Department of Veterans Affairs (DVA) hospitals. This large contemporary review examines the outcomes of surgical treatment and is also the largest reported series of attempted colonoscopic decompressions. All patients with the ICD-9-CM code for colonic volvulus during the period 1991-1995 were identified in the computerized national DVA database. Data on patient demographics, clinical course, and outcomes were collected. Fifty-five patients with cecal volvulus and complete medical records were identified. The average age was 68 years; all were male. Previous abdominal surgery (5 of 55 patients; 9%), and neurologic impairment (6 of 55 patients; 11%) were the most common risk factors. Diagnosis was possible by plain radiography in the majority of patients (39 of 55; 71%). Colonoscopic decompression was attempted in 20 patients (36%), but was successful in only one (5%). The mortality rate was 18% for colectomy and primary anastomosis (5 of 28 procedures), 31% for colectomy and stoma formation (5 of 16 procedures), 11% for cecopexy (1 of 9 cases), and 100% for tube cecostomy (2 procedures). Mortality was significantly correlated with emergent surgery (p < 0.01). Cecal volvulus frequently presents as a surgical emergency, and continues to be associated with a high mortality rate. Prompt diagnosis is often possible with plain radiographs, but colonoscopic decompression is typically unsuccessful. Cecopexy provides a safe alternative to resection and primary anastomosis in suitably selected patients.

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Section: Discussionmentioning

confidence: 44%

Cecal volvulus: outcome of management by celiotomy

Grossmann

Johnson

Enger

et al. 2000

Techniques in Coloproctology

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“…Cecopexy and cecostomy seem less-effective and more morbid options than resection and anastomosis for viable bowel. [3][4][5]9,11 This fact has been confirmed by dissection of adult male cadavers by Wolfer et al 11 who have shown that 11 percent of the population has a cecum sufficiently mobile to allow the development of torsion. V olvulus is a condition wherein a loop of bowel and its mesentery twist on a fixed point at the base.…”

mentioning

confidence: 94%

“…Diagnostic doubt is not uncommon in cecal volvulus; nonoperative decompression is rarely achievable; and if gangrene supervenes, mortality rises appreciably. 1,2,9 In the conventional ileocolic volvulus the torsion is usually a counterclockwise rotation in an oblique fashion, also displacing the ileum. Cecopexy and cecostomy seem less-effective and more morbid options than resection and anastomosis for viable bowel.…”

mentioning

confidence: 99%

“…Resection is mandatory for gangrene and a grossly distended, thin-walled cecum. 1,9 In cecal bascule the cecum rotates in a horizontal plane anteriorly upward, with the obstruction at the point of folding 1,9,10 A prerequisite for cecal volvulus to occur is an abnormal mobility of the cecum that results from improper developmental fusion of the mesentery of the cecum and the ascending colon with the posterior parietal peritoneum in the right gutter. However, their role needs reappraisal in the light of advances in minimally invasive techniques.…”

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confidence: 99%

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The Management of Cecal Volvulus

Madiba

Thomson

Church

2002

Diseases of the Colon &Amp; Rectum

198

224

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Cecal volvulus is second only to sigmoid volvulus in its frequency of occurrence. Diagnostic doubt is not uncommon in cecal volvulus; nonoperative decompression is rarely achievable; and if gangrene supervenes, mortality rises appreciably. Resection is mandatory for gangrene and a grossly distended, thin-walled cecum. Cecopexy and cecostomy seem less-effective and more morbid options than resection and anastomosis for viable bowel. However, their role needs reappraisal in the light of advances in minimally invasive techniques.

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“…11 Although a diagnosis is rarely made on clinical grounds alone, it has been reported that radiological abnormalities in plain abdominal radiography are identifi able in nearly all patients with cecal volvulus. The features are (a) a greatly distended cecum in an ectopic position, most commonly in the left upper quadrant of the abdomen, and (b) a distended small intestine often located to the right of the cecum producing a "kidney shape."…”

Section: Discussionmentioning

confidence: 99%

Cecal volvulus in cerebral palsy: Report of a case

et al. 2008

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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.

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Volvulus of the Cecum and Right Colon

Cited by 20 publications

References 5 publications

Cecal volvulus: outcome of management by celiotomy

Cecal volvulus: outcome of management by celiotomy

The Management of Cecal Volvulus

Cecal volvulus in cerebral palsy: Report of a case

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