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Rapid Isolation of Viable Circulating Tumor Cells from Patient Blood Samples
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Is Loop Ileostomy in Patients with Cecal Bascule a Viable Option?

Tushar Shetty1, Tommy Ivanics2, Hassan Nasser2

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Summary

Cecal bascule, a rare bowel obstruction, disproportionately affects patients with cerebral palsy. Surgical intervention is crucial, as a diverting loop ileostomy alone is insufficient for effective treatment.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Cecal bascule, a rare form of cecal volvulus, involves anterior folding of a redundant cecum, causing intestinal obstruction.
  • Patients with cerebral palsy (CP) exhibit an increased risk for developing cecal bascule due to functional dependence.

Observation:

  • A 28-year-old male with CP presented with a prolapsed loop ileostomy, secondary to an inverted cecum through the efferent limb.
  • The patient had a history of loop ileostomy for cecal bascule.

Findings:

  • The patient underwent a right hemicolectomy with end ileostomy and transverse mucous fistula creation.
  • Postoperative recovery was uneventful, with successful management of the cecal bascule complication.

Implications:

  • Cecal bascule necessitates surgical management; a loop ileostomy alone is not a definitive treatment.
  • Early recognition and surgical intervention are vital in managing cecal bascule to reduce morbidity and mortality in at-risk populations.
  • A high index of suspicion is crucial for diagnosing large bowel obstruction in patients with cerebral palsy.