title: Cecal volvulus caused by a large uterine leiomyoma.
abstract: BACKGROUND
  Cecal volvulus is a relatively uncommon encountered clinical condition.
  
  
  METHODS
  A 48-year-old patient known with a large uterine leiomyoma, presented with progressive abdominal pain since one week. An abdominal computed tomography scan revealed a very large leiomyoma of the uterus, severely distended loops of the small bowel with a caliber change and a suggested 'whirl sign' of the mesenteric vessels. A laparotomy was performed, showing a very large uterus as well as torsion of the mesentery of the cecum with a sharp demarcated area of necrosis of the right hemicolon.
  
  
  CONCLUSIONS
  Cecal volvulus due to a large uterine mass is a rare encountered clinical entity. The suggested mechanism might be the same mechanism causing cecal volvulus during pregnancy; the enlarged uterus raisingout the mobile cecum out of the pelvis. Obstruction may occur from kinking of the colon at a fixed point.
  
  
  CONCLUSIONS
  This case demonstrates that uterine leiomyoma can be a cause of a cecal volvulus, leading to severe intestinal strangulation.
authors.affiliation: Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands. Electronic address: aaheelkvriesh@zgv.nl.
authors.forename: Hilbert S
authors.initials: HS
authors.lastname: de Vries
authors.affiliation: Department of Gyneacology, Gelderse Vallei Hospital, Ede, The Netherlands.
authors.forename: Raoul K
authors.initials: RK
authors.lastname: Samlal
authors.affiliation: Department of Radiology, Gelderse Vallei Hospital, Ede, The Netherlands.
authors.forename: Bas J
authors.initials: BJ
authors.lastname: Maresch
authors.affiliation: Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands.
authors.forename: Miriam L
authors.initials: ML
authors.lastname: Hoven-Gondrie
keywords: Cecal volvulus; Right hemicolectomy; Uterine leiomyoma
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