A Case of Cecal Volvulus Successfully Managed With Transnasal Ileus Tube Decompression Followed by Elective...

Cecal volvulus is a rare but potentially life-threatening cause of colonic obstruction. Emergency surgery is standard but is associated with high morbidity and mortality, especially in high-risk patients. Therefore, non-operative management may be an important alternative in selected cases. A 90-year-old man presented to the emergency department with abdominal distension and pain. He was diagnosed with cecal volvulus without evidence of intestinal necrosis, accompanied by right lower lobe atelectasis and pleural effusion, both attributed to compression of the lung secondary to massive colonic distension. Given the absence of necrosis and the high anesthetic risk associated with advanced age and underlying pulmonary compromise, non-operative management was initiated using a transnasal ileus tube. Successful detorsion was confirmed on day 7 post-insertion, and the patient was discharged. Elective laparoscopic ileocecal resection was performed subsequently to prevent recurrence. Postoperative pneumonia was noted, but no other complications occurred, and the patient was discharged on postoperative day 19. At the 11-month follow-up, the patient remained in good health with no evidence of recurrence. We report a case of cecal volvulus without intestinal necrosis successfully managed by transnasal ileus tube decompression followed by elective laparoscopic ileocecal resection. This approach may be a viable option to avoid emergency surgery in high-risk patients and expands the therapeutic options for elderly individuals.