Recurrent cecocolic torsion: radiological diagnosis and treatment

Recurrent cecocolic torsion may cause recurrent right lower abdominal pain and right-sided thrust dyspareunia. It is seldom considered in the differential diagnosis of pain in this region. The propensity of the cecocolon to torse is secondary to the double developmental defect of a mobile cecocolon compounded by an elongated and overrotated organ that can be eccentrically located in the abdomen. The torsion may result in recurrent obstructions with spontaneous resolutions, but it may proceed to an acute episode of obstruction and strangulation with a more profound morbidity and mortality rate. The diagnosis of recurrent cecocolic torsion is verified by a plain x-ray film of the abdomen, contrast enema, and computed tomography scan. The preferred treatment is outpatient laparoscopic cecocolopexy. Laparoscopic or classical open cecocolectomy and right hemicolectomy are reserved for more complex and morbid presentations.