Cecal Volvulus Diagnosed with a Whirl Sign: A Case Report

Area of Science:

• Gastroenterology
• Abdominal Surgery

Background:

• Cecal volvulus accounts for approximately 1.9% of colonic obstructions in the US.
• Typical presentation involves abdominal distension and tenderness, but variations exist.
• Atypical presentations necessitate a broad differential diagnosis for abdominal pain.

Purpose of the Study:

• To highlight the importance of considering cecal volvulus in patients with abdominal pain.
• To emphasize the diagnostic utility of the "whirl sign" in computed tomography (CT) for identifying cecal volvulus.
• To underscore the need for emergent surgical consultation when cecal volvulus is suspected.

Main Methods:

• Case report of a 64-year-old female with right upper quadrant abdominal pain.
• Utilized computed tomography (CT) for diagnosis, identifying the characteristic "whirl sign."
• Surgical intervention included detorsion and right hemicolectomy.

Main Results:

• Computed tomography (CT) accurately diagnosed cecal volvulus via the "whirl sign."
• Emergent surgery resulted in a full recovery.
• Normal bowel function returned by post-operative day 3 with no adverse effects.

Conclusions:

• The "whirl sign" on CT is a key indicator for cecal volvulus.
• Prompt surgical intervention is critical for favorable outcomes in cecal volvulus.
• Maintaining a wide differential diagnosis is essential for managing abdominal pain, even in unusual locations.