title: An Unusual Case of Caecal Volvulus due to Appendicitis, Successfully Managed by Caecopexy.
abstract: Caecal volvulus is a rare cause of intestinal obstruction. Caecal volvulus precipitated by acute appendicitis is even rarer. We report an unusual case of caecal volvulus with acute appendicitis as a cause. A 55-year female presented in surgical emergency with 3 days history of abdominal pain, distension and absolute constipation; and 2 days history of vomiting. Her past surgical history was significant for hysterectomy 5 years back. On examination, abdomen was distended and bowel sounds exaggerated. X-ray abdomen erect showed a single large air fluid level in the right hemiabdomen. A preoperative diagnosis of intestinal obstruction due to adhesions was made and patient prepared for exploratory laparotomy. On exploration, a huge caecum was lying in the midline and was twisted around a band arising from the appendix and attached deep into the pelvis. The appendix was densely inflammed. The volvulus was de-twisted in a counter clockwise manner. Viability of the caecum was confirmed and appendectomy was done. Caecopexy was performed and abdomen was closed. Postoperative recovery of the patient was uneventful and she was safely discharged on 5th postoperative day.
authors.affiliation: Surgical Unit 2, Services Hospital, Lahore.
authors.forename: Samiullah
authors.initials: S
authors.lastname: Bhatti
authors.affiliation: Surgical Unit 2, Services Hospital, Lahore.
authors.forename: Mahmood Ayyaz
authors.initials: MA
authors.lastname: Khan
authors.affiliation: Surgical Unit 2, Services Hospital, Lahore.
authors.forename: Waris
authors.initials: W
authors.lastname: Farooka
authors.affiliation: Surgical Unit 2, Services Hospital, Lahore.
authors.forename: Usman Ismat
authors.initials: UI
authors.lastname: Butt
authors.affiliation: Surgical Unit 2, Services Hospital, Lahore.
authors.forename: Usman Ali
authors.initials: UA
authors.lastname: Rehman
authors.affiliation: Surgical Unit 2, Services Hospital, Lahore.
authors.forename: Awais Amjad
authors.initials: AA
authors.lastname: Malik
mesh_terms: D001062:Appendectomy; D001064:Appendicitis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002429:Cecal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged