Caecal bascule is an uncommon type of caecal volvulus in which the caecum 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 caecal bascule may occur in the setting of a large and mobile caecum and can result in closed obstruction involving the caecal pole and appendix.
Clinical presentation and treatment are not significantly different from 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, improving one's confidence that the caecum 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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