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Cecal bascule in a child: an unusual cause of postoperative bowel obstruction

David A Lazar1, Seth A Cohen, Darryl K Evora

  • 1Department of Surgery, University of California at San Diego, San Diego, CA 92103, USA.

Journal of Pediatric Surgery
|March 20, 2012
PubMed

Insights

Cecal bascule, a rare intestinal obstruction, is reported for the first time in a child with trisomy 13 syndrome. This condition requires consideration in pediatric postoperative bowel obstruction, recommending surgical management.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Motility Disorders
  • Congenital Anomalies

Background:

  • Cecal bascule is an uncommon cause of intestinal obstruction, typically seen in adults.
  • It involves the upward folding of a mobile cecum, leading to ascending colon obstruction.
  • This case highlights a rare pediatric presentation.

Observation:

  • A 4-year-old child with trisomy 13 syndrome developed cecal bascule 5 days post-laparoscopic Nissen fundoplication.
  • Initial diagnosis was delayed, requiring intraoperative cecal reduction.
  • The condition recurred after one year, necessitating a cecostomy tube for decompression and fixation (cecopexy).

Findings:

  • This is the first reported pediatric case of cecal bascule.
  • The patient experienced recurrent obstruction despite initial surgical intervention.
  • Successful management involved cecostomy tube placement for decompression and cecopexy.

Implications:

  • Cecal bascule should be included in the differential diagnosis for early postoperative bowel obstruction in children, particularly those with developmental delays and post-laparoscopic surgery.
  • Operative management, including cecopexy or resection, is recommended for pediatric cecal bascule.
  • This case expands the understanding of cecal bascule in pediatric surgical emergencies.

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