Diagnosis: Cecal Volvulus
Clinical Presentation:
- Cecal volvulus is a condition in which the cecum, a part of the large intestine, becomes twisted or rotated, leading to obstruction.
- Patients with cecal volvulus may present with symptoms such as abdominal pain, distension, nausea, and vomiting.
- In some cases, patients may develop signs of sepsis due to ischemia and necrosis of the affected bowel.
Findings on Imaging:
- Imaging studies such as abdominal x-ray, or CT may show evidence of a distended cecum and abnormal positioning of the bowel loops.
- A “coffee bean” sign may be seen on imaging, representing the twisted and elongated appearance of the cecum and ascending colon.
- In some cases, imaging may also show signs of bowel ischemia or necrosis.
Next Steps in Management:
- Management of cecal volvulus typically involves emergent surgery to relieve the obstruction and prevent further complications.
- Surgery may involve detorsion of the bowel and repositioning of the cecum, or removal of the affected bowel segment if it is necrotic.
- In some cases, a stoma may be created to allow for healing of the bowel before a second operation is performed to restore normal bowel continuity.
Key Take Away Points:
- Cecal volvulus is a condition in which the cecum becomes twisted or rotated, leading to obstruction.
- Imaging studies such as abdominal x-ray, or CT can help diagnose cecal volvulus by showing evidence of a distended cecum and abnormal positioning of the bowel loops, as well as signs of bowel ischemia or necrosis.
- Management of cecal volvulus typically involves emergent surgery to relieve the obstruction and prevent further complications.
Case submitted by Dr. Saeed Rad to radRounds Radiology Network
