Surgical management of cecal volvulus: a case report

Abstract

A volvulus occurs when a loop of the intestine twists around itself and the supporting mesentery, accounting for 1–1.5% of all intestinal obstruction cases. Approximately one quarter of the colonic volvuli are cecal, with women being up to 80% of the cases. Surgical intervention, particularly right hemicolectomy, is preferred owing to the high risk of recurrence. An 84-year-old Colombian woman presented with a 1-week history of generalized abdominal pain, constipation, anorexia, and emesis. Physical examination revealed abdominal distension, Kocher and infraumbilical midline surgical scars, diffuse superficial tenderness, involuntary guarding, and hyperperistalsis. An acute abdomen series revealed radiologic findings consistent with cecal volvulus. Postoperatively, the patient had an uneventful recovery and resumed oral intake on the third postoperative day. At the 1-month follow-up, she remained free of complications. Although rare, cecal volvulus is a multifactorial condition that should be considered in the differential diagnosis of intestinal obstruction, particularly in patients with predisposing factors. Early surgical intervention is crucial to reduce morbidity and mortality and to prevent severe future complications.