[Cecal volvulus].
The cecum is the second most common site of colonic volvulus after the sigmoid. The mechanism is torsion or hyperflexion of the enlarged, poorly-fixed, and hypermobile cecum. It presents clinically as an acute bowel obstruction with strangulation. Diagnosis can be made by plain abdominal X-ray in more than half the cases on the basis of cecal distention (with a classical "teardrop" or "comma" appearance), proximal small bowel distention with air-fluid levels, and a gasless distal colon. Barium enema shows lack of filling of the cecum, often with a "beaked" termination of the column of contrast. CT images are pathognomonic when they reveal a cecal "vortex". After surgical reduction of the torsion, ileo-cecal resection is usually the best therapeutic alternative. Cecopexy may be aDDrouriate in older and debilitated Datients if there is no concomitant cecal necrosis.
Abita
T
T
Service Chirurgie Viscérale et Transplantation, CHU Dupuytren, Limoges.
Lachachi
F
F
Durand-Fontanier
S
S
Maisonnette
F
F
Roudaut
P Y
PY
Valleix
D
D
Descottes
B
B
D001464:Barium; D002429:Cecal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000379:methods; D004733:Enema; D006801:Humans; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging* / Q000601:surgery*; D011379:Prognosis; D014057:Tomography, X-Ray Computed
D001464:Barium