Cecal volvulus: case report

Abstract

Introduction: Cecal volvulus is a rare cause of intestinal obstruction, characterized by the axial rotation of the cecum and ascending colon around the mesenteric vasculature. This torsion can lead to tissue necrosis and intestinal perforation. Timely diagnosis and appropriate management can reduce mortality. Case report: A 43-year-old woman presented to the emergency department with nonspecific abdominal symptoms. A computed tomography scan suggested intestinal torsion, prompting an exploratory laparotomy. A cecal volvulus with extensive necrosis was identified, necessitating a right hemicolectomy and detorsion as a damage control approach. Discussion: Cecal volvulus is a pathological condition with multiple predisposing factors, among which a history of abdominal surgery is particularly significant. Diagnosis relies on laboratory studies and imaging techniques, with abdominal computed tomography being the most sensitive and specific modality. Management is primarily surgical, ranging from detorsion to colectomy, depending on intestinal viability and the patient’s hemodynamic stability. In cases of irreversible intestinal ischemia, colectomy with or without ileostomy is necessary to mitigate damage and prevent complications. Conclusions: Cecal volvulus is a rare cause of intestinal obstruction, characterized by nonspecific symptoms and accelerated progression. Early diagnosis, as well as surgical treatment, are essential to reducing complications.