Three Surgical Cases of Cecal Volvulus

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Imaging

Background:

• Cecal volvulus (CV) is a rare cause of acute abdomen, often necessitating emergency surgery.
• Unlike sigmoid volvulus, endoscopic detorsion for CV has a low success rate.
• Understanding CV pathophysiology is critical due to its potential for fatal outcomes if treatment is delayed.

Observation:

• This report presents three distinct surgical cases of cecal volvulus (CV) treated within a short timeframe.
• Patients included elderly individuals with comorbidities, presenting with abdominal fullness or pain.
• Computed tomography (CT) effectively diagnosed CV in all presented cases.

Findings:

• Emergency surgery was required for all three patients diagnosed with CV.
• Indocyanine green (ICG) fluorescence imaging confirmed intact blood flow in one case, leading to cecopexy.
• Intestinal ischemia and strangulation were observed in two cases, necessitating ileocecal resection.

Implications:

• CT is a valuable tool for diagnosing cecal volvulus.
• Prompt surgical intervention is crucial for managing CV, with treatment tailored to intraoperative findings.
• Intraoperative techniques like ICG imaging and procedures such as cecopexy or resection play vital roles in successful CV management.