Management of cecal volvulus in debilitated patients

We retrospectively evaluated ten cases of cecal volvulus. The average age of these patients was 57 years. Five patients were more more than 60 years old and three were over 70. All patients had significant delays in coming to the hospital, and all had concomitant medical problems that made them poor operative risks. Our data and data in the recent literature support a conservative approach in debilitated patients with acute cecal volvulus. We do not recommend resection of the cecum if it is viable at the time of operation. Resection remains the treatment of choice when gangrene is present, but primary ileotransverse colostomy is contraindicated in this population of patients.