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Acute caecal volvulus: A diagnostic paradigm.

Tariq Hassan Chaudry1, Munawar Jamil1, Khurram Niaz1

  • 1Surgical Ward III, QAMC/BV Hospital. Bahawalpur.

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Summary

Acute Caecal Volvulus, a rare cause of intestinal obstruction, presents with specific symptoms like right lower quadrant pain and distention. Early diagnosis through clinical suspicion and radiology is crucial for effective management.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Acute Caecal Volvulus is an uncommon cause of intestinal obstruction.
  • This study retrospectively analyzes cases presenting to a single emergency department.

Purpose of the Study:

  • To describe the clinical features, radiological findings, and management outcomes of Acute Caecal Volvulus.
  • To emphasize the importance of clinical suspicion and early radiological diagnosis.

Main Methods:

  • Retrospective review of 11 cases of Acute Caecal Volvulus among 1032 intestinal obstruction cases (June 2008-June 2013).
  • Analysis of patient demographics, presenting symptoms, radiological findings, surgical interventions, and postoperative complications.

Main Results:

  • Mean age was 36 years, with a female predominance.
  • Common symptoms included chronic intermittent pain, right lower quadrant colicky pain, and abdominal distention.
  • Radiological findings showed a dilated cecum with air-fluid levels in most cases.
  • Right hemicolectomy with primary anastomosis was the most frequent surgical procedure.
  • Wound sepsis and chest infection were the most common complications.

Conclusions:

  • Acute Caecal Volvulus diagnosis hinges on clinical suspicion, particularly RLQ pain relieved by flatus passage.
  • Early radiological assessment is vital for prompt diagnosis and management of intestinal obstruction due to caecal volvulus.