Caecal volvulus with iatrogenic complication

Case contributed by Dr Matthew Jarvis

Presentation

Acute onset abdominal pain and vomiting. Post insertion of flatus tube. Still not decompressed.

Patient Data

Age: 89
Gender: Female
Modality: CT

Non-contrast CT abdomen demonstrates the rectal tube penetrating the sigmoid colon in the left iliac fossa with its distal end extending into the mesentery/omentum in the left upper abdomen. Approximately 16 cm of tube is extraluminal. There is an additional finding of a large infrarenal abdominal aortic aneurysm. The intraperitoneal flatus tube is visualised in contact with the left wall of the AAA.

The caecum appears transposed into the pelvis and mid abdomen with a maximal diameter of 13 cm with evidence of tight obstruction of the proximal ascending colon. No obvious twisting/transition point.

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Case Information

rID: 36806
Case created: 11th May 2015
Last edited: 3rd Oct 2015
Inclusion in quiz mode: Included

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