Laparoscopic surgery for repeated cecal volvulus with intestinal malrotation: A case report

Area of Science:

• Gastroenterology and Surgical Innovation
• Minimally Invasive Surgery Techniques

Background:

• Cecal volvulus is a rare but serious condition, particularly in advanced-age patients.
• Previous laparotomy for cecal volvulus increases the risk of recurrence.
• Intestinal malrotation can be an underlying cause of recurrent cecal volvulus.

Observation:

• A 96-year-old female patient presented with recurrent cecal volvulus after prior laparotomy.
• Initial laparoscopic surgery to untwist and fix the cecum was followed by recurrence.
• Preoperative CT scans did not reveal signs of intestinal malrotation due to anatomical positioning.

Findings:

• A second laparoscopic surgery successfully treated recurrent cecal volvulus by fixing the colon to the abdominal wall.
• The underlying cause was diagnosed as intestinal malrotation, previously undetected.
• Laparoscopic surgery is a viable option for cecal volvulus associated with intestinal malrotation, even in obstructed cases.

Implications:

• Intestinal malrotation should be considered in cases of recurrent cecal volvulus, even in elderly patients.
• Laparoscopic surgery offers a minimally invasive approach for managing complex cecal volvulus with malrotation.
• This case expands the understanding of laparoscopic surgery's utility in advanced-age patients with gastrointestinal emergencies.