Presentation
Abdominal pain, abdominal distension and vomiting.
Patient Data
A grossly dilated large bowel loop is seen extending from the right lower quadrant towards the right upper quadrant giving the shape of an embryo. A large air-fluid level is seen within it on the erect film. There is dilatation of the small bowel loops with prominent valvulae conniventes and multiple air-fluid levels seen within it. Paucity of gas is noted in the rectum.
The cecum is grossly dilated with a twist of its mesentry giving the embryo appearance. There is resultant gross dilatation of the small bowel loops with multiple air-fluid levels seen within it suggesting small bowel obstruction. The large bowel loops are collapsed.
Case Discussion
Cecal volvulus results from torsion of the cecum around its mesentry leading to proximal large bowel obstruction. Clinical presentation may include colicky abdominal pain, abdominal distension and vomiting. Complications may include perforation and fecal peritonitis if not diagnosed early. This patient underwent surgery where a grossly dilated, perforated, torsed cecum was found.