title: Colonic tumour precipitating caecal volvulus within a diaphragmatic hernia.
abstract: An 85-year-old woman presented with sudden onset of generalised abdominal pain and absolute constipation for 4 d. On examination she had a distended abdomen. Plain abdominal radiograph revealed a gas filled viscous within the left upper quadrant. Subsequent computed tomography suggested caecal volvulus herniated through a left diaphragmatic hernia. The patient underwent reduction of the internal hernia, right hemicolectomy and mesh repair of the diaphragmatic hernia. Postoperative recovery was uneventful. Histology revealed a Dukes' A colonic cancer within the caecum. Herniation of caecal volvulus through a diaphragmatic hernia is a very rare condition and may have been precipitated by the colonic tumour.
authors.affiliation: Ricky Harminder Bhogal, Rajan Patel, Department of Gastroenterological Surgery, Dudley Group of Hospitals, Russell's Hall Hospital, West Midlands DY1 2HQ, United Kingdom.
authors.forename: Ricky Harminder
authors.initials: RH
authors.lastname: Bhogal
authors.forename: Kambiz
authors.initials: K
authors.lastname: Maleki
authors.forename: Rajan
authors.initials: R
authors.lastname: Patel
keywords: Bowel ischaemia; Bowel obstruction; Caecal volvulus; Colonic cancer; Diaphragmatic hernia