Keywords
Caecum
Acute intestinal obstruction
Niamey
Niger
How to Cite
Abstract
Introduction :
Caecal volvulus is a rare condition and an exceptional cause of intestinal obstruction. It is a medico-surgical emergency. Prognosis depends on early management.
Observation :
We report a case of volvulus of the cecum in a 31-year-old patient admitted for diffuse abdominal pain of abrupt onset with cessation of matter and gas 48 hours prior to admission associated with fecal vomiting. The patient was stable. The abdomen was distended, asymmetric and tympanic, with diffuse abdominal tenderness. On rectal examination, the rectal ampulla was empty. An unprepared abdominal X-ray revealed a left subdiaphragmatic hydroaeric level. Biological workup showed predominantly neutrophilic hyperleukocytosis, with elevated C-reactive protein. The rest of the work up was normal. The diagnosis of acute intestinal obstruction was made and exploratory laparotomy was indicated. Intraoperatively, a dilated caecum was found, with two turns of the spiral around its meso. An ileocecal resection with terminal-lateral ileocolic anastomosis was performed. Postoperative follow-up was straightforward, with 24-hour transit resumption and normal resumption of daily activities after seven months.
Conclusion :
Caecal volvulus is a rare cause of intestinal obstruction. The etiopathogenesis involves a mobile cecum with little attachment of the ascending colon to the retroperitoneum. Management of this condition must not be delayed in order to reduce the morbidity and mortality associated with it.
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