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The management of cecal volvulus
1Department of Surgery, University of Natal, Durban, South Africa.
Diseases of the Colon and Rectum
|February 20, 2002
Summary
Cecal volvulus, a common condition, often presents diagnostic challenges and rarely responds to nonoperative decompression. Resection is typically required for gangrene or severely distended cecum, though minimally invasive techniques may alter treatment approaches.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Cecal volvulus is a significant cause of bowel obstruction, second only to sigmoid volvulus.
- Diagnosis can be challenging, and nonoperative management is often unsuccessful.
Purpose of the Study:
- To review the diagnostic and management strategies for cecal volvulus.
- To evaluate the efficacy and safety of different surgical interventions.
Main Methods:
- Review of existing literature on cecal volvulus.
- Analysis of diagnostic modalities and treatment outcomes.
- Discussion of surgical techniques including resection, anastomosis, cecopexy, and cecostomy.
Main Results:
- Gangrene and cecal distention necessitate resection.
- Resection with anastomosis appears superior to cecopexy or cecostomy for viable bowel.
- Mortality increases significantly with gangrene.
Conclusions:
- Resection is the standard treatment for complicated cecal volvulus.
- Minimally invasive approaches warrant further investigation for cecal volvulus management.