Presentation
Acute right sided abdominal pain and distension
Patient Data
The caecum appears distended, folds up over itself in an anteromedial orientation. A "whirl sign" is seen composed of a spiraled loop of the collapsed caecum and twisting mesentery. No evidence of proximal bowel obstruction.
The red arrow points to the distended folded caecum and the green arrow points to the whirl sign.
Case Discussion
Caecal bascule is an uncommon variant of caecal volvulus in which the caecum folds up over itself in an anteromedial orientation without any torsion. It may occur in the setting of a large and mobile caecum and can result in closed bowel obstruction. In this case, the patient followed conservative treatment with improvement. No surgery was performed.
This case is contributed by Dr Mohamed Elthokapy.
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