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Cecal bascule after cardiac surgery: A case report.

Angela M Johnson1, Soon Park2, Francis T Lytle1

  • 1Department of Anesthesia and Perioperative Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Annals of Cardiac Anaesthesia
|April 11, 2020
PubMed
Summary

Cecal bascule, a rare bowel obstruction, can be fatal if untreated. This report details the first known case following cardiac surgery, highlighting a critical surgical complication.

Keywords:
Abdominal paincecal basculecolon dilatationcoronary artery bypasscoronary artery diseaseintestinal volvulus

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Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Cardiothoracic Surgery

Background:

  • Cecal bascule is a rare cause of large bowel obstruction, accounting for 0.01% of adult cases.
  • It involves upward and anterior cecal folding, potentially leading to closed-loop obstruction, ischemia, and gangrene.
  • Untreated cecal bascule carries a 50% mortality rate, with nonoperative management having a 95% failure rate.

Observation:

  • Severe gastrointestinal complications can arise post-cardiothoracic surgery.
  • This is the first reported instance of cecal bascule occurring after cardiac surgery.
  • The case highlights a unique and severe complication following cardiothoracic procedures.

Findings:

  • Cecal bascule, a form of volvulus, presents a significant risk of mortality and morbidity.
  • Right hemicolectomy is the definitive treatment with a low recurrence rate.
  • The occurrence post-cardiac surgery underscores the need for vigilance regarding GI complications.

Implications:

  • This case expands the known spectrum of gastrointestinal complications following cardiothoracic surgery.
  • It emphasizes the importance of recognizing and promptly treating cecal bascule, especially in post-surgical patients.
  • Further investigation into the mechanisms linking cardiac surgery to cecal bascule may be warranted.