Caecal Volvulus Presenting as the Obstructed Right Inguinal Hernia

Mahalingam Sudharshan,Uday Kumbhar,Rajapriyan Panneerselvam,Oseen Shaikh,Naveen Kumar Gaur

doi:10.7759/cureus.16264

Abstract

Caecal volvulus is an uncommon cause of intestinal obstruction with varied clinical presentation. Surgical intervention without delay is considered the gold standard in its management. Strangulated inguinal hernia with caecal volvulus is a rarity. We report a case of a 55-year-old male with a history of long-standing right inguinal hernia, presented with the irreducibility of the hernia along with pain for one day. Clinically patient was diagnosed to have an obstructed inguinal hernia. On exploration, we found that there was a caecal volvulus in the hernia sac along with gangrene of the distal ileum, redundant sigmoid, and ascending colon. Resection and anastomosis of the gangrenous segment of the bowel were done along with herniorrhaphy and sigmoidopexy. Postoperatively patient improved without any complication.

Highlights

Colonic volvulus is an axial twisting of a segment of the colon around its mesentery
Caecal volvulus has a varied clinical spectrum ranging from recurrent intermittent pain to acute fulminant intestinal obstruction
NeMoyer et al reported a case of caecal volvulus in left-sided inguinal hernia with loss of domain causing closed-loop obstruction and perforation, where the abnormal axial rotation of the bowel could be attributed to loss of domain [4]

Summary

Introduction

Colonic volvulus is an axial twisting of a segment of the colon around its mesentery. Classical caecal volvulus is the clockwise, axial twisting of the terminal ileum, caecum, and ascending colon around its mesentery. It is an uncommon cause of intestinal obstruction [1]. Caecal volvulus in a strangulated inguinal hernia is very rare. The patient had mild pain over the swelling since it became irreducible. How to cite this article Sudharshan M, Shaikh O, Panneerselvam R, et al (July 08, 2021) Caecal Volvulus Presenting as the Obstructed Right Inguinal Hernia. The patient was diagnosed with an obstructed right inguinal hernia. We found a volvulus of 100 cm of the terminal ileum, caecum, and part of ascending colon.

Discussion

Conclusions

Disclosures