IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Cecal volvulus

Case contributed by Matthew Lukies
Diagnosis certain

Presentation

Severe generalized abdominal pain. No bowel movement for 2 days.

Patient Data

Age: 60 years
Gender: Female
ct
  • distended cecum (up to 9 cm)
  • displaced cecum towards the left upper quadrant
  • twisting of vessels (whirl sign) around the proximal ascending colon / cecum just distal to the ileocecal valve
  • pericaecal free fluid tracking into the pelvis

Case Discussion

The findings of this CT were conveyed to the treating surgical registrar and the patient proceeded to undergo a right hemicolectomy.

The pathological macroscopic findings confirmed the diagnosis of cecal volvulus, with:

  • dilated cecum and ascending colon
  • thinned bowel wall (<1 mm)
  • grey/purple serosal surface

No malignant lesion was identified. No features of ischemia on microscopic examination.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.