58 The Unfolding Situation of Caecal Volvulus: A Review of 36 Cases

Abstract

Abstract Aim Caecal Volvulus is a rare cause of bowel obstruction. However, there has been a steady rise in the number of cases over the decades. The demographic profile of patients developing Caecal Volvulus has changed to a much older population. We conducted a retrospective review to find the incidence, demographic profile, management, and outcomes of Caecal Volvulus patients in our institution during the last nine years. Method A total of 38 patients were diagnosed with Caecal Volvulus at Worcestershire Acute Hospitals NHS Trust between 01.01.2011 to 31.03.2020. Results Most of our patients were females (78%) with a median age was 76 years. The majority (86%) had at least one medical comorbidity, and 36% had a previous abdominal operation. Abdominal pain was the main complaint in 94% of patients. All patients had a CT scan to confirm their diagnosis. Most of our patients (84%) underwent surgery. Open right hemicolectomy was the most commonly performed operation (87%). Out of the six patients who did not undergo surgery, three responded to bowel rest and nasogastric tube decompression; one patient underwent successful colonoscopic decompression. In contrast, two patients, unfortunately, passed away. The median length of hospital stay was 9 days, with a 30-day mortality of 3%. Conclusion Caecal Volvulus remains a rare cause of bowel obstruction. Most of our patients were old, frail and had medical comorbidities. More than a third of them had undergone previous abdominal surgery. Early CT scan followed by surgery was associated with low mortality.