Caecal Volvulus Research Articles

Vólvulo del ciego, una entidad infrecuente como causa de abdomen agudo en embarazadas: Reporte de caso clínico y revisión de la literatura

Introducción. El vólvulo cecal en el embarazo es una patología infrecuente a nivel mundial, con un espectro clínico variado y limitación en estudios diagnósticos, lo que puede resultar en un desenlace ominoso.
 Caso clínico. Se presenta el caso de una gestante en segundo trimestre del embarazo quien presenta abdomen agudo secundario a vólvulo cecal y sufrimiento fetal. La paciente fue llevada a cesárea de urgencia, donde además se practicó cecectomía y anastomosis íleo transversa, con mortalidad fetal.
 Discusión. El vólvulo cecal forma parte de los diagnósticos diferenciales en caso de abdomen agudo durante el embarazo. Tiene un pronóstico reservado, en donde pueden presentarse desenlaces maternos y perinatales adversos, con mortalidad maternofetal.

Somatostatin receptor scintigraphy in the follow up of neuroendocrine neoplasms of appendix.

BACKGROUNDNeuroendocrine tumors of appendix (ANETs) known as carcinoids, are rare endocrine neoplasms originated from enterochromaffin cells of gastrointestinal tract. ANETs are the third most frequent (16.7%) gastrointestinal neuroendocrine tumors, with the incidence of 0.08-0.2 cases/100000 during one year. Incidental ANETs occur in 0.2%-0.7% of emergency surgical resections because of suspected appendicitis which is usually the first manifestation of ANET. Although there are a lot of papers about application of somatostatin receptor scintigraphy in gastrointestinal neuroendocrine tumors, there are very rare sporadic cases described about ANETs particularly.AIMTo establish the role of somatostatin receptor scintigraphy (SRS) in the management of patients with neuroendocrine tumors of appendix (ANET).METHODSThe total of 35 patients was investigated, 23 females and 12 males, average age (43.7 ± 17.3 years). All patients had histological diagnosis of ANET (34 carcinoids of appendix and one tubular carcinoid). Majority of tumors have been found incidentally during surgery of: Acute appendicitis (n = 15), perforated appendicitis (n = 2), ileus (n = 3), hysterectomy (n = 3), ruptured ovarian cyst (n = 2), caecal volvulus (n = 1), while 9 patients had diagnosis of appendiceal tumor before the surgery. Seventeen patients had tumor grade (G) G1, 12 G2 and 6 G3. The right hemicolectomy was performed in 13, while the rest of the patients had appendectomy only. SRS was done early (2 h) and late (24 h) after i.v. application of 740 MBq technetium-99m ethylenediamine-N, N'-diacetic acid Hydrazinonicotinyl-Tyr3-Octreotide (technetium-99m-Tektrotyd, Polatom, Poland). SRS was performed for restaging in all the patients after surgery.RESULTSThere were 12 true positive (TP), 19 true negative, 3 false positive and 1 false negative SRS result. Sensitivity of the method was 92.31%, specificity was 86.36%, positive predictive value was 80.00%, negative predictive value was 95.00% and accuracy 88.57%. Receiver operating characteristics analysis showed that SRS scintigraphy is a good test for detection TP cases [area under the curve of 0.850, 95% confidence interval (CI): 0.710-0.990, P < 001]. Single photon emission computed tomography contributed diagnosis in 7 TP findings. In 10 patients Krenning score was 4 and in 2 was 3. In 8 patients SRS significantly changed the management of the patients (in two surgery was repeated, in 4 somatostatin analogues and in two peptide receptor radionuclide therapy). Median progression-free survival in SRS positive patients was 52 months (95%CI: 39.7-117.3 mo) while in SRS negative patients it was 60 months (95%CI: 42.8-77.1 mo), without statistically significant difference between the two groups (P = 0.434).CONCLUSIONIn conclusion, our results confirmed the value of SRS in the follow-up of the patients with ANET after surgery, if recurrences or metastases are suspected.

Caecal volvulus in a twin pregnancy: dilemma of a delayed diagnosis

Caecal volvulus in a twin pregnancy: dilemma of a delayed diagnosis

To evaluate role of various clinical and diagnostics procedures in diagnosis of caecal perforation

Study includes hundred patients admitted to surgical emergency with acute abdomen were selected for the study. There was not any preoperative selection criteria; the cases which were proven to be cases of perforation peritonitis on the basis of investigations and clinical examination were taken for study and considered for comparative study if laparotomy diagnosed to be case of caecal perforation. Inflammatory cause 22 cases (22%) which include caecal perforation secondary to ruptured liver abscess 14 cases, appendicular base with caecal wall perforation 4 cases. Obstructive cause 06 cases (06 %) include obstructed inguinal hernia 02 case, obstructive band 02 case and caecal volvulus 03 case. 04 cases (04%) of caecal perforation secondary to neoplastic etiology were studied. The common etiologies in descending order were Traumatic 68 cases (68%) which include multiple stab injury 40 cases (40%), blunt trauma abdomen 12 cases (12%), iatrogenic 10 cases (10%), caecal perforation secondary to arrow injury 1 case (2%), and blast injury 2 case (4%). Chi Square Test of statistical significance was applied between group A (right hemicolectomy with ileo transverse anastomosis) and group B (primary repair with omental patch, primary repair with proximal ileostomy and right hemicolectomy with ileo transverse colostomy) for testing association between between group A and group B. From total Nine parameters chi square test was found to be significant in seven parameters with p value 0.05. Reducing mortality in patients undergoing surgery for caecal perforations. Ileostomy-specific complications, however, increase the postoperative stay of the patient. These complications can be reduced, if not outright eliminated, by proper fashioning of the stoma and provision of adequate nursing care of the stoma. It should be recommended that ileostomy in these cases is only temporary and the extra cost and cost of management are burden to life of poor community.

Lesser sac hernia containing caecal volvulus precipitating bowel obstruction during pregnancy.

Lesser sac hernia containing caecal volvulus precipitating bowel obstruction during pregnancy.

Colectomy for caecal and sigmoid volvulus: a national analysis of outcomes and risk factors for postoperative complications.

Colonic volvulus is a common entity encountered by colorectal surgeons, but there are few reports of national data regarding postoperative outcomes. The aim of this study was to describe the volvulus population, 30-day outcomes following right- and left-sided colectomy and risk factors for postoperative complications. The American College of Surgeons National Surgical Quality Improvement Program Database from 2012 to 2015 was utilized to identify patients with the diagnosis of 'volvulus' who underwent right- or left-sided colectomy. Primary outcomes were overall morbidity and mortality. A total of 2175 patients were identified (661 right colectomy and 1514 left colectomy). Risk factors for complications following right-sided colectomy included: age, male gender, smoker, systemic inflammatory response syndrome, sepsis, septic shock and American Society of Anesthesiologsts class≥4. Risk factors for complications following left-sided colectomy included: age, male gender, systemic inflammatory response syndrome, sepsis and septic shock. Several nonmodifiable risk factors were identified for complications following colectomy for volvulus. These risk factors can be used in patient/family counselling and discharge planning.

Caecal Volvulus: An Uncommon Disease with Common Presentation

Ceacal volvulus was first noted by Hildanus in the 16th century and later reviewed by Rokitansky in 1837. It is the second most common site for volvulus of intestine.

A Case of Intestinal Obstruction due to Synchronous Caecal and Sigmoid Volvulus

A Case of Intestinal Obstruction due to Synchronous Caecal and Sigmoid Volvulus

Caecal volvulus, a rare complication of abdominoplasty

Caecal volvulus, a rare complication of abdominoplasty

A perforated caecal volvulus in the foramen of Winslow

The aim of this report is to discuss with high-quality images, a case of a caecal volvulus herniating through the foramen of Winslow with signs of perforation.

Caecal volvulus: A sequel of cholecystitis

Caecal volvulus is a sobriquet, which is described anatomically by abnormal omphalic rotation of the right hemi colon. It is an infrequently encountered clinical condition with higher prevalence in women and an anomalous cause of intestinal obstruction. Patients with this condition may present with greatly vacillating clinical symptoms ranging from discontinuous, self-limiting abdominal pain to acute abdominal pain associated with intestinal strangulation and sepsis. Paucity of experience with this condition is a factor contributing to diagnostic and treatment delays. It has been reported that radiological abnormalities are identifiable in nearly all patients with acute caecal volvulus. It is generally agreed that patients with acute caecal volvulus benefit from surgical intervention for correction of intestinal obstruction. We report the first case of an atypical cause of a caecal volvulus, which was not initially identified from the abdominal computed tomography. We present the case, discuss management and discuss literature.

CAECAL VOLVULUS

Caecal volvulus is a rare cause of intestinal obstruction. In this report, we presenta 35 year-old old Female patient with Caecal volvulus, and we discuss this very rare entity.

English

Caecal volvulus is a rare cause of intestinal obstruction. In this report, we presenta 35 year-old old Female patient with Caecal volvulus, and we discuss this very rare entity.

Elective laparoscopic right colectomy for caecal volvulus: Case report and literature review

Caecal volvulus is an uncommon cause of intestinal obstruction. Its clinical presentation is non-specific, with the diagnosis usually confirmed by barium enema and abdominal computed tomography. Treatment depends on many factors, and minimally invasive approaches are becoming the treatment of choice.A 54 years old female, admitted to the Emergency Department with clinical symptoms of intestinal obstruction. On physical examination she had a palpable, firm, and tympanitic mass in the right abdomen, with peritoneal irritation. The radiographs of the abdomen, barium enema and abdominal computed tomography showed caecal volvulus. As she showed a full remission after the barium enema, with no clinical or biochemical data of systemic inflammatory response syndrome or peritoneal irritation, she was discharged to her home. Two weeks later, a laparoscopic right hemicolectomy was performed with an ileo-transverse extracorporeal anastomosis. Her progress was satisfactory, and she was discharged 4 days after surgery due to improvement.Caecal volvulus is a rare cause of intestinal obstruction, with high mortality rates, and is caused by excessive mobility of the caecum. Its incidence is increasing. Treatment depends on many factors. Early non-surgical untwisting, followed by an elective laparoscopic surgical procedure offers several advantages and reduces mortality.

Peer review report 2 on “A case of caecal volvulus mimicking Ogilvie syndrome in a hospitalized patient with a pelvis fracture”

Peer review report 2 on “A case of caecal volvulus mimicking Ogilvie syndrome in a hospitalized patient with a pelvis fracture”

Peer review report 1 on “A case of caecal volvulus mimicking Ogilvie syndrome in a hospitalized patient with a pelvis fracture”

Peer review report 1 on “A case of caecal volvulus mimicking Ogilvie syndrome in a hospitalized patient with a pelvis fracture”

Caecal Volvulus As a Rare Cause of Intestinal Obstruction: Case Report and Review of the Literature

Caecal Volvulus As a Rare Cause of Intestinal Obstruction: Case Report and Review of the Literature

Caecal volvulus: a rare cause of intestinal obstruction in pregnancy

Caecal volvulus: a rare cause of intestinal obstruction in pregnancy

Caecal volvulus a rare presentation of acute intestinal obstruction in a 22 year old female

Acute intestinal obstruction due to cecal volvulus forms an uncommon cause when there is axial twist of the cecum, ascending colon and terminal ileum around their mesenteric pedicles. There are many etiologies and predisposing factors for cecal volvulus, but the exact etiology is most likely to be multifactorial in presence of mobile cecum. It is the rarity and non specific presentation that makes the preoperative diagnosis to be rarely achieved in most cases.

English

Caecal volvulus is a rare condition and caecal bascule, a variant of caecal volvulus is even rarer. Despite similar clinical presentation, initial vigil during clinical examination helps in furthering the diagnosis. The objective of treatment in case of caecal volvulus is to avoid any complication such as gangrene with resection being the only choice if gangrene has already developed. The present case of a 53 year old male, is a typical representation of a caecal volvulus complicated by presence of gangrene confirmed on laparotomy. Resection of 5.7 cm of involved gangrenous part averted any further complication. Follow-up and reversal of ileostomy was done after 6 weeks with an ileo-ascending anastomosis. No complication was reported during the follow up. INTRODUCTION: Cecal volvulus is a rare condition, and its incidence is reported to range from 2.8 to 7.1 per million people per year [1]. It is characterised anatomically by the axial twisting that occurs involving the caecum, terminal ileum, and ascending colon [2, 3]. Caecal bascule is a variant of this condition associated with the upward and anterior folding of the ascending colon and accounts for about 10% of all caecal volvulus case sp [3]. Despite anatomical differentiation, the clinical profile of caecal volvulus and caecal bascule is very similar and is often manifested in terms of intestinal obstruction and strangulation [2, 3]. Clinical presentation of volvulus cases is very diverse and is characterized by intermittent episodes of abdominal pain to unbearable pain leading to medical emergencies [3, 4]. Owing to its rare occurrence, it is difficult to diagnose. In this paper, we report a case of cecal volvulus with extremely rare caecal bascule variant seen in a 55-year-old man, diagnostic method, treatment planning and management of the case is discussed CASE REPORT: A 55 year old male presented with complaints of pain for the last 5 days followed by distension of abdomen for the last 2 days. He was also vomiting for the past 24-hours. On examination, generalized distension with tenderness was felt. Tympanic note over left upper quadrant was noticed. There were no bowel sounds and no evidence of sepsis. Erect X-Ray of abdomen showed dilated small bowel loops with a large gas-filled loop with haustrations placed obliquely which are characteristic of caecal bacsule. On exploratory laparotomy, caecum & appendix were found to be gangrenous and lying over splenic flexure of colon. Resection of gangrenous segment 5.7 cm in length was done with exteriorization of ileum & ascending colon. Patient recovered and was discharged with ileostomy in situ on day ___. Follow-up and reversal of ileostomy was done after 6 weeks with an ileo-ascending anastomosis.