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Is Loop Ileostomy in Patients with Cecal Bascule a Viable Option?
Tushar Shetty1, Tommy Ivanics2, Hassan Nasser2
1Wayne State University School of Medicine, Detroit, MI, USA.
Case Reports in Surgery
|August 21, 2019
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.
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.
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