Cecal bascule

Last revised by Dr Matt A. Morgan on 27 Jul 2021

Cecal bascule is an uncommon type of cecal volvulus in which the cecum folds up over itself in an anteromedial orientation. In contrast to the more common forms of volvulus, there is no axial "twisting" component 4.  A cecal bascule may occur in the setting of a large and mobile cecum and can result in closed obstruction involving the cecal pole and appendix.

Clinical presentation and treatment are not significantly different from the more common axial cecal volvulus.

Radiographic features

Plain radiograph

An abdominal radiograph of a patient with a cecal bascule will demonstrate a distended air-filled cecum located centrally within the abdomen. Occasionally the appendix is distended and air-filled, improving one's confidence that the cecum is obstructed more distally.

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

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Cases and figures

  • Case 1: radiograph
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