Cecal volvulus - atypical

Case contributed by Dr Chris O'Donnell

Presentation

Acute right upper quadrant pain

Patient Data

Age: 75 years
Gender: Female
CT

Cecum has gone from normal right iliac fossa position (previous scan) to enter the space between liver and hemidiaphragm (current scan), taking the ileo-colic artery with it. Distended cecum and small bowel (obstruction) with adjacent free fluid, indicating the possibility of venous ischemia in the volved segment. Note how the liver has become grossly distorted by the markedly distended cecum.

1 month earlier

CT

Situation one month earlier.

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