Cecal volvulus

Case contributed by Milad Mohammad MollaGhanbari
Diagnosis certain

Presentation

An elderly female living at a nursing home presented with abdominal pain and distension, with constipation for two days.

Patient Data

Age: 85 years
Gender: Female

Lateral Decubitus View

x-ray

Large pneumoperitoneum and cecal air-fluid level is visible.

Supine AP view

x-ray

In supine plane, a dilated cecum (up to 14cm) with coffee bean sign originating from RLQ region along with air lucency in both paracolic gutters is visible.
Also dilatation of small bowels without large bowels is an important finding that suggests the volvulus location is the cecum.

Photo

Extremely dilated cecum

Case Discussion

The patient was emergently transferred to OR and sudden air jet out happened.
Cecopexy was done.

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