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[Intermittent cecal volvulus. Report of 2 cases]
1Servicio y Departamento de Cirugía, Hospital Clínico San Borja-Arriarán, Facultad de Medicina, Universidad de Chile, Santiago de Chile.
Revista Medica De Chile
|November 1, 1993
Summary
Intermittent cecal volvulus, often overlooked, causes recurrent abdominal distention. Early diagnosis and surgical fixation of the ascending colon offer effective treatment for this rare condition.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Abdominal Surgery
Context:
- Acute cecal volvulus accounts for 3.3% of mechanical large bowel obstructions.
- Over half of these cases present with a history suggestive of intermittent cecal volvulus, a frequently misdiagnosed condition.
- Recurrent abdominal distention in the right lower quadrant, relieved by gas expulsion or defecation, is a key symptom.
Purpose:
- To highlight the underdiagnosis of intermittent cecal volvulus.
- To present two successful surgical case treatments for intermittent cecal volvulus.
- To emphasize the diagnostic and surgical management of this condition.
Summary:
- Two female patients, aged 45 and 71, with a history of 3-5 years of recurrent right lower quadrant abdominal distention were treated for intermittent cecal volvulus.
- Initial misdiagnosis occurred in one case, leading to an unnecessary sigmoidectomy before cecopexia was performed. The second case was diagnosed via barium enema, followed by cecopexia.
- Both patients underwent surgical fixation of the ascending colon (cecopexia) and remain asymptomatic post-operatively (9 years and 2 years, respectively).
Impact:
- This report underscores the importance of suspecting intermittent cecal volvulus in patients with chronic, recurrent abdominal distention.
- Barium enema is a crucial diagnostic tool for confirming the condition.
- Surgical fixation of the ascending colon provides a definitive and effective treatment, resolving symptoms and preventing recurrence.