Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations]
Caecal volvulus (CV) is a rare cause of intestinal obstruction, defined by an axial torsion of the caecum, ascending colon, and terminal ileum around the mesenteric vascular pedicles, leading to ischemia and bowel necrosis. A 20-year-old woman, with no significant medical history, was admitted for g...
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| Format: | Article |
| Language: | English |
| Published: |
F1000 Research Ltd
2022-11-01
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| Series: | F1000Research |
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| Online Access: | https://f1000research.com/articles/11-781/v2 |
| _version_ | 1811323678744379392 |
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| author | Sami Bouchoucha Hajer Sebri Oussema Baraket Ahmed Itaimi Wissem Triki Karim Ayed Imed Abbassi Racem Trigui Ramy Ben Salah |
| author_facet | Sami Bouchoucha Hajer Sebri Oussema Baraket Ahmed Itaimi Wissem Triki Karim Ayed Imed Abbassi Racem Trigui Ramy Ben Salah |
| author_sort | Sami Bouchoucha |
| collection | DOAJ |
| description | Caecal volvulus (CV) is a rare cause of intestinal obstruction, defined by an axial torsion of the caecum, ascending colon, and terminal ileum around the mesenteric vascular pedicles, leading to ischemia and bowel necrosis. A 20-year-old woman, with no significant medical history, was admitted for generalized abdominal pain evolving for three days, along with constipation and abdominal distension, but with no vomiting. Physical examination showed a generalized abdominal tenderness with no rigidity or rebound tenderness, associated with abdominal distension and tympanic upon percussion. Laboratory findings were within normal limits. An abdominal computed tomography scan revealed distension of a loop of the large bowel with its long axis extending from the right lower quadrant to the epigastrium or left upper quadrant. Colonic haustral pattern was absent. An abdominal computed tomography scan showed a rounded focal collection of air-distended bowel with haustral creases in the upper left quadrant. In addition, spiraled loops of the collapsed cecum (giving a whirl sign) were noted, along with low-attenuating fatty mesentery from the twisted bowel. The patient underwent an emergency laparotomy and caecectomy using GEA 80 charges. The patient had no complaints post-operation. CV is a rare cause of bowel obstruction, mainly caused by an exceedingly mobile caecum. Despite its rareness, CV represents the second most common cause of large bowel volvulus, behind sigmoid volvulus. For acute obstruction by CV, it is hard to differentiate it clinically from obstruction of the small bowel; therefore, radiological exams are needed. Surgery is the gold standard treatment for CV. We report a rare case of CV to highlight the rarity of this pathology, specify its diagnostic and therapeutic means, and its clinical and biological evolution. |
| first_indexed | 2024-04-13T13:59:28Z |
| format | Article |
| id | doaj.art-1aaabac665324699a3ae1947a80744cd |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-04-13T13:59:28Z |
| publishDate | 2022-11-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-1aaabac665324699a3ae1947a80744cd2022-12-22T02:44:05ZengF1000 Research LtdF1000Research2046-14022022-11-0111139079Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations]Sami Bouchoucha0Hajer Sebri1Oussema Baraket2Ahmed Itaimi3https://orcid.org/0000-0002-3263-4070Wissem Triki4Karim Ayed5Imed Abbassi6https://orcid.org/0000-0002-4802-2132Racem Trigui7Ramy Ben Salah8General Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaGynecology and Obstetric Department, Hospital Mongi Slim of La Marsa, Tunis, 1000, TunisiaGeneral Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaGeneral Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaGeneral Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaGeneral Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaGeneral Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaGeneral Surgery Department, Hôpital Universitaire Bougatfa of Bizerte, Bizerte, 7000, TunisiaPlastic and Reconstructive Department, Hospital Habib Bougatfa of Bizerte, Bizerte, 7000, TunisiaCaecal volvulus (CV) is a rare cause of intestinal obstruction, defined by an axial torsion of the caecum, ascending colon, and terminal ileum around the mesenteric vascular pedicles, leading to ischemia and bowel necrosis. A 20-year-old woman, with no significant medical history, was admitted for generalized abdominal pain evolving for three days, along with constipation and abdominal distension, but with no vomiting. Physical examination showed a generalized abdominal tenderness with no rigidity or rebound tenderness, associated with abdominal distension and tympanic upon percussion. Laboratory findings were within normal limits. An abdominal computed tomography scan revealed distension of a loop of the large bowel with its long axis extending from the right lower quadrant to the epigastrium or left upper quadrant. Colonic haustral pattern was absent. An abdominal computed tomography scan showed a rounded focal collection of air-distended bowel with haustral creases in the upper left quadrant. In addition, spiraled loops of the collapsed cecum (giving a whirl sign) were noted, along with low-attenuating fatty mesentery from the twisted bowel. The patient underwent an emergency laparotomy and caecectomy using GEA 80 charges. The patient had no complaints post-operation. CV is a rare cause of bowel obstruction, mainly caused by an exceedingly mobile caecum. Despite its rareness, CV represents the second most common cause of large bowel volvulus, behind sigmoid volvulus. For acute obstruction by CV, it is hard to differentiate it clinically from obstruction of the small bowel; therefore, radiological exams are needed. Surgery is the gold standard treatment for CV. We report a rare case of CV to highlight the rarity of this pathology, specify its diagnostic and therapeutic means, and its clinical and biological evolution.https://f1000research.com/articles/11-781/v2caecal volvulus whirl sign caecopexy caecectomyeng |
| spellingShingle | Sami Bouchoucha Hajer Sebri Oussema Baraket Ahmed Itaimi Wissem Triki Karim Ayed Imed Abbassi Racem Trigui Ramy Ben Salah Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations] F1000Research caecal volvulus whirl sign caecopexy caecectomy eng |
| title | Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations] |
| title_full | Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations] |
| title_fullStr | Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations] |
| title_full_unstemmed | Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations] |
| title_short | Case Report: Caecal volvulus management from diagnosis to treatment in a young patient [version 2; peer review: 2 approved, 1 approved with reservations] |
| title_sort | case report caecal volvulus management from diagnosis to treatment in a young patient version 2 peer review 2 approved 1 approved with reservations |
| topic | caecal volvulus whirl sign caecopexy caecectomy eng |
| url | https://f1000research.com/articles/11-781/v2 |
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