A Case Report on Cecal Volvulus: Approach to Management

Abstract

Cecal volvulus is a rare cause of intestinal obstruction caused by axial twisting of the cecum that occurs in 1–1.5 % of all intestinal obstruction, with an incidence of 2.8–7.1 cases per million annually. Cecal volvulus is potentially life-threatening without prompt surgical intervention. A 57-year-old woman presented with severe abdominal pain and distention. Laboratory examinations revealed normal white blood cell count with neutrophilic predominance. Diagnosis of acute cecal volvulus was made from a “whirl sign” on abdominal computed tomography. An exploratory laparotomy confirmed the diagnosis of cecal volvulus and a segmental ileocolic resection with primary anastomosis was carried out. The patient was discharged improved and returned to her normal activities of daily living. Conclusion: The management of volvulus involves a series of stepwise decisions that must be performed rapidly. Due to the fact that this condition is relatively uncommon makes it more critical for surgeons to maintain a solidified algorithm tailored to the disease process in order to amplify chances of successful outcome. In this case, the diagnosis of acute cecal volvulus was made from a “whirl sign” on abdominal computed tomography. An exploratory laparotomy confirmed the diagnosis of cecal volvulus and a segmental ileocolic resection with primary anastomosis was carried out. The patient was discharged, improved. Key words: Cecal volvulus, ileo-colectomy, whirl sign