Caecal bascule

Caecal bascule is an uncommon type of caecal volvulus. It occurs in a large and mobile caecum that folds up over itself resulting in closed obstruction to the caecal pole and appendix.

Clinical presentation and treatment are not significantly different to the more common axial caecal volvulus.

Radiographic features

Plain radiograph

An abdominal radiograph of a patient with a caecal bascule will demonstrate a distended air-filled caecum located centrally within the abdomen. Occasionally the appendix is distended and air-filled, significantly aiding in the interpretation of the film.

Importantly, as the terminal ileum is usually not involved in the volvulus, the small bowel is not obstructed.