Cecal volvulus

Case contributed by Irvine Sihlahla
Diagnosis certain

Presentation

Abdominal pain, vomiting for 3 days. No diarrhea, fever or cough

Patient Data

Age: 35 years
Gender: Female

Abdominal series

x-ray

Large loop of bowel arising from the right iliac fossa pointing towards the left upper quadrant with associated dilated central loops of small bowel with multiple air fluid levels. The left colon and sigmoid colon are collapsed. No pneumoperitoneum. Cholestectomy clips noted.

ct

Dilated loop of bowel with haustra in keeping with a dilated cecum. The two limbs of the obstructed cecum converge in the right hemipelvis with a bird's beak appearance. Upstream small bowel obstruction with collapsed large bowel. Incidental hepatic cysts and mildly prominent biliary ducts.

Case Discussion

The imaging findings are consistent with cecal volvulus which was confirmed at surgery. Differential for cecal volvulus includes sigmoid volvulus.

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