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Case Reports
. 2009 May 28;15(20):2547-9.
doi: 10.3748/wjg.15.2547.

Cecal volvulus: report of a case and review of Japanese literature

Toshio Katoh  1 , Tsunehiko Shigemori, Ryo Fukaya, Hiroshi Suzuki
Affiliations
Case Reports

Cecal volvulus: report of a case and review of Japanese literature

Toshio Katoh et al. World J Gastroenterol. .

Abstract

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.

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Figures

Figure 1
Figure 1
A “coffee-bean sign” on an abdominal CT film.
Figure 2
Figure 2
A “beak sign” on a gastrographin-enema.
Figure 3
Figure 3
Operative finding after detorsion of axial torsion of the right colon. Ischemia of the bowel seemed to be irreversible, but there was no perforation.
See this image and copyright information in PMC

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