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Cecal volvulus caused by a large uterine leiomyoma
Hilbert S de Vries1, Raoul K Samlal2, Bas J Maresch3
1Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands.
International Journal of Surgery Case Reports
|March 31, 2015
Summary
A large uterine leiomyoma can cause cecal volvulus, a rare condition leading to bowel obstruction. This case highlights uterine fibroids as a potential cause of cecal volvulus and intestinal strangulation.
Area of Science:
- Gastroenterology
- Gynecology
- Surgical Case Reports
Background:
- Cecal volvulus is an uncommon cause of intestinal obstruction.
- Large uterine leiomyomas are typically benign gynecological tumors.
- Uterine masses can exert mass effect on adjacent organs.
Purpose of the Study:
- To report a rare case of cecal volvulus secondary to a large uterine leiomyoma.
- To elucidate the potential mechanism of cecal volvulus in this context.
- To highlight uterine leiomyoma as a differential diagnosis for acute abdominal pain.
Main Methods:
- Case presentation of a 48-year-old female with abdominal pain.
- Diagnostic imaging including abdominal computed tomography (CT) scan.
- Surgical intervention via laparotomy for diagnosis and management.
Main Results:
- CT revealed a large uterine leiomyoma, distended small bowel, and a 'whirl sign'.
- Laparotomy confirmed uterine torsion of the cecum with right hemicolon necrosis.
- Surgical findings indicated cecal volvulus caused by the uterine mass.
Conclusions:
- Uterine leiomyoma can precipitate cecal volvulus, a rare clinical entity.
- The enlarged uterus may displace the mobile cecum, leading to torsion.
- This case underscores the importance of considering gynecological pathology in acute abdominal presentations.
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