title: Cecal bascule in a child: an unusual cause of postoperative bowel obstruction.
abstract: Cecal bascule is a rare type of intestinal obstruction that occurs when a mobile cecum folds upward and obstructs the ascending colon. Most often occurring in the elderly, we present the first reported case of cecal bascule in a child. The cecal bascule occurred in a 4-year-old with trisomy 13 syndrome 5 days after a laparoscopic Nissen fundoplication. After a delay in diagnosis and cecal reduction in the operating room, the bascule recurred after 1 year, and the child was treated with a cecostomy tube for both cecopexy and cecal decompression. Cecal bascule should be considered in the differential diagnosis of children with early postoperative bowel obstruction, especially in the developmentally delayed status-post laparoscopic surgery. For the pediatric patient with cecal bascule, we recommend operative management with either cecopexy or resection.
authors.affiliation: Department of Surgery, University of California at San Diego, San Diego, CA 92103, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Lazar
authors.forename: Seth A
authors.initials: SA
authors.lastname: Cohen
authors.forename: Darryl K
authors.initials: DK
authors.lastname: Evora
authors.forename: Barry E
authors.initials: BE
authors.lastname: Losasso
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Bickler
mesh_terms: D002429:Cecal Diseases / Q000175:diagnosis* / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology; D010535:Laparoscopy; D011183:Postoperative Complications / Q000175:diagnosis*