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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
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Cecal volvulus after open right hepatectomy
Lasse R Jensen1, Niclas Dohrn1, Luit Penninga1,2
1Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Journal of Surgical Case Reports
|February 13, 2025
Summary
This case report details cecal volvulus, a rare bowel obstruction, occurring after right hepatectomy. Early recognition and surgical intervention are crucial for managing this postoperative complication.
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Cecal volvulus is an uncommon cause of bowel obstruction, characterized by the twisting of the cecum and its mesentery.
- It poses a significant risk of bowel ischemia and necrosis, necessitating prompt diagnosis and management.
Observation:
- A rare instance of cecal volvulus was observed in a patient in her 70s following an open right hepatectomy.
- The patient presented with abdominal distension and pain on postoperative day six, leading to the suspicion of bowel obstruction.
Findings:
- Computed tomography (CT) scan confirmed bowel obstruction, and emergency laparotomy revealed a cecal volvulus with a highly mobile cecum.
- The condition necessitated a right hemicolectomy with end-ileostomy due to sepsis. Postoperative recovery was complicated by paralysis and fascial dehiscence.
Implications:
- This is the first documented case of cecal volvulus following right hepatectomy, suggesting altered anatomy and postoperative paralysis as potential contributing factors.
- The case highlights the importance of considering cecal volvulus in the differential diagnosis of postoperative bowel obstruction, particularly after surgeries involving the right-sided abdominal structures.
