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.