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Cecal volvulus.

R Rabinovici1, D A Simansky, O Kaplan

  • 1Department of Surgery, Hadassah Medical Center, Jerusalem, Israel.

Diseases of the Colon and Rectum
|September 1, 1990
PubMed
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Cecal volvulus, a serious condition, increasingly affects older women. Surgical outcomes vary, with detorsion recommended for viable cecum and resection for necrotic cases, while cecostomy should be avoided.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Surgery

Background:

  • Cecal volvulus is a rare but life-threatening cause of bowel obstruction.
  • Understanding its evolving demographics and optimal surgical management is crucial.

Purpose of the Study:

  • To characterize the clinical and laboratory profile of cecal volvulus.
  • To evaluate and compare the efficacy and safety of different surgical interventions for cecal volvulus.

Main Methods:

  • A comprehensive review of 561 published cases (1959-1989) and 7 new cases.
  • Analysis of patient demographics, clinical presentation, diagnostic imaging, and surgical outcomes.

Main Results:

  • A shift towards older patients (mean age 53) and female predominance (1.4:1) was observed.

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  • Barium enema demonstrated high accuracy (88%) with minimal complications.
  • Detorsion alone and cecopexy showed similar complication/mortality rates; resection had higher rates, and cecostomy had the highest (52% complications, 22% mortality).

    • Conclusions:

    • Detorsion is effective for viable cecum; resection is indicated for necrotic cecum.
    • Cecostomy is associated with high complication and mortality rates and should be abandoned.