Cecal volvulus

Case contributed by Dr Chris O'Donnell

Presentation

Abdominal pain and distention with nausea.

Patient Data

Age: 50 years
Gender: Female
CT

Scout view showing a markedly distended large bowel loop in the left side of the abdomen. CT demonstrates the large bowel mass is a grossly distended food-filled cecum that is not in the right iliac fossa but in the left side of the abdomen. The axial slices clearly show the ileum passing through a 360-degree rotation to enter the abnormally positioned cecum.

Annotated image

The terminal ileum (yellow) and ascending colon (blue) can be traced to whirl around each other, the mesenteric vessels (red) acting as the axis of rotation. The appendix is also visible, distended by gas and fluid. 

Case Discussion

This case illustrates fairly typical appearances of a cecal volvulus. 

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Case information

rID: 16702
Published: 12th Feb 2012
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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