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. 2015:10:97-9.
doi: 10.1016/j.ijscr.2015.03.021. Epub 2015 Mar 13.

Cecal volvulus caused by a large uterine leiomyoma

Hilbert S de Vries  1 , Raoul K Samlal  2 , Bas J Maresch  3 , Miriam L Hoven-Gondrie  4
Affiliations

Cecal volvulus caused by a large uterine leiomyoma

Hilbert S de Vries et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Cecal volvulus is a relatively uncommon encountered clinical condition.

Presentation of case: 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.

Discussion: 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.

Conclusion: This case demonstrates that uterine leiomyoma can be a cause of a cecal volvulus, leading to severe intestinal strangulation.

Keywords: Cecal volvulus; Right hemicolectomy; Uterine leiomyoma.

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Figures

Fig. 1
Fig. 1
A computed tomography (CT) scan of the abdomen showed a very large leiomyoma of the uterus, distended loops of the small bowel with a caliber change of the small bowel in the right upper quadrant (A) as well as a suggested ‘whirl sign’ of the mesenteric vessels (B).
Fig. 2
Fig. 2
Specimen of ischemic right hemicolon.
See this image and copyright information in PMC

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