Cecal volvulus: report of a case and review of Japanese literature.
A 78-year-old woman presented with fever, severe abdominal pain, and distension. She had been institutionalized for depression and senile dementia. Laboratory examinations disclosed a leucocytosis (WBC: 12,500/microL) and elevated levels of serum C-reactive protein (2.8 mEq/L). Diagnosis of acute cecal volvulus was made from a "coffee bean sign" on an abdominal computed tomography and a "beak sign" on a gastrographin enema. An emergent laparotomy confirmed the diagnosis and an ileo-colectomy with primary anastomosis was carried out. The patient recovered after intensive respiratory care and fluid therapy, and then returned to her former institution. A review of Japanese literature disclosed that: (1) a marked increase of aged patients with mental disability presenting with cecal volvulus, (2) adoption of ileo-colectomy as the standard surgical procedure, and (3) improved survival of the patients, were observed in the last decade.
Katoh
Toshio
T
Division of Surgery, Toyama Hospital, Tsu-City, Japan.
Shigemori
Tsunehiko
T
Fukaya
Ryo
R
Suzuki
Hiroshi
H
D000368:Aged; D002432:Cecum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D007564:Japan; D011859:Radiography