出版社：International Medical Journal Management and Indexing System
摘要：Caecal volvulus is a very rare clinical entity and it constitutes less then 1% of all intestinal occlusions in adult. But, prompt diagnosis is crucial due to the possibility of ishaemia and necrosis in case of a delay in treatment. 22-year-old male patient was admitted to our department with the diagnosis of intestinal obstruction. His past medical history included the diagnosis of metastatic Ewing sarkoma and he took radiotherapy to whole body before admission. Physical examination revealed abdominal distension with decreased bowel peristaltism, but guarding was not obtained. Radiologic imaging methods demonstrated a markedly caecal dilatation with absence of gas in the remaining colon and a single airï¬uid level in the right lower quadrant. Despite a 48-hour conservative treatment with nasogastric tube decompression and fluid-electrolyte resuscitation, abdominal distension did not resolve and patients labaratory tests including LDH detoriated. As the muscular rigidity developed, surgical exploration was decided. Upon entry into the abdomen, we confirmed dilated caecum that had twisted 270 degrees on its mesentery (Fig. 1). Surgical detorsion and caecopexy was performed since there was not any signs of ischemia and peritonitis (Fig 2). The patients postoperative period was uneventful and he was discharged 7 days later. Although caecal volvulus is a rare entity, its clinical results can be fatal in case of a delay in diagnosis and treatment. So, clinicians should be aware of this life-threatening issue.
