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Cecal volvulus: review of 12 cases
1Department of Surgery, Eastern Virginia Medical School, Norfolk.
Southern Medical Journal
|October 1, 1988
Summary
Cecal volvulus, a rare cause of intestinal obstruction, presents with distention and pain. Surgical management varies, with cecopexy for viable colon and ileocolectomy for gangrenous colon showing the lowest complication rates.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Abdominal Surgery
Background:
- Cecal volvulus is an uncommon cause of intestinal obstruction.
- Understanding its incidence and management is crucial for patient outcomes.
Purpose of the Study:
- To determine the incidence, presentation patterns, and surgical management of cecal volvulus.
- To evaluate the efficacy and complication rates of different surgical interventions.
Main Methods:
- Retrospective review of 109 patients diagnosed with intestinal obstruction due to volvulus between 1966 and 1985.
- Analysis of presenting symptoms, diagnostic methods (plain films, barium enema), and surgical treatments (detorsion, cecopexy, tube cecostomy, ileocolectomy).
Main Results:
- Cecal volvulus was identified in 12% of patients with intestinal obstruction.
- Common symptoms included distention (83%) and pain (58%).
- Plain films had a 45% diagnostic rate; barium enema was diagnostic in 83% of cases. Delayed diagnosis led to gangrene in two patients, with one death. Treatments included simple detorsion, cecopexy, tube cecostomy, and ileocolectomy. Simple detorsion showed no recurrence. Cecopexy and ileocolectomy had the lowest complication rates.
Conclusions:
- Cecal volvulus requires prompt diagnosis and appropriate surgical intervention.
- Cecopexy for viable cecum and ileocolectomy for gangrenous cecum are associated with favorable outcomes.