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Case Reports
. 2014 Apr 11;2014(4):rju025.
doi: 10.1093/jscr/rju025.

Bascule caecal volvulus: a rare cause of intestinal obstruction

Jason Ramsingh  1 , Robert Hodnett  2 , Trudy Coyle  3 , Ahmed Al-Ani  2
Affiliations
Case Reports

Bascule caecal volvulus: a rare cause of intestinal obstruction

Jason Ramsingh et al. J Surg Case Rep. .

Abstract

Caecal volvulus is a rare cause of intestinal obstruction, with the bascule subtype accounting for <10% of all cases of caecal volvulus. It is associated with significant morbidity and mortality if left undiagnosed. We present the case of a 58-year-old female who presented to our surgical department with symptoms of intestinal obstruction. She had various radiological investigations, which supported the diagnosis of a caecal volvulus of the bascule subtype. She was subsequently managed surgically and had a right hemicolectomy and ileocolic anastomosis. Her recovery was uneventful and she was discharged within 1 week of having her operation. Fortunately, caecal volvulus of the bascule subtype is rarely encountered; however, clinicians need to be aware of its presentation and subsequent management options so that clinical outcomes are improved.

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Figures

Figure 1:
Figure 1:
Erect chest radiograph, showing a large hiatus hernia and large loop of bowel elevating the right hemidiaphragm.
Figure 2:
Figure 2:
CT coronal section demonstrating caecum medially displacing the liver and causing an upward pressure on the right hemidiaphragm.
Figure 3:
Figure 3:
A large bowel contrast study showing the flow of contrast from the collapsed transverse colon into the dilated, upwardly displaced caecum.
Figure 4:
Figure 4:
Coronal section of contrast-enhanced CT demonstrating contrast filling upwardly displaced caecum.
Figure 5:
Figure 5:
Axial section of contrast-enhanced CT demonstrating ‘whirl sign’ at the point of volvulus.
Figure 6:
Figure 6:
Freely mobile, distended caecum found on opening.
See this image and copyright information in PMC

References

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