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Case Reports
. 2018 Mar 14;2(2):139-142.
doi: 10.5811/cpcem.2018.2.37073. eCollection 2018 May.

An Unlikely Cause of Abdominal Pain

Norah Kairys  1 , Keegan Skidmore  1 , Jennifer Repanshek  1 , Wayne Satz  1
Affiliations
Case Reports

An Unlikely Cause of Abdominal Pain

Norah Kairys et al. Clin Pract Cases Emerg Med. .

Abstract

Cecal bascule is a rare subtype of cecal volvulus where the cecum folds anterior to the ascending colon causing intestinal obstruction. It is a challenging diagnosis to make in the emergency department, as the mobile nature of the cecum leads to a great deal of variation in its clinical presentation. Our discussion of a 78-year-old female who presented with abdominal pain and was found to have a cecal bascule requiring right hemicolectomy, demonstrates how emergency physicians must expand their differential diagnosis for patients reporting signs of intestinal obstruction. Though cecal bascule does not present often, the need for early surgical intervention necessitates a high level of clinical suspicion to prevent life-threatening complications.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1
Image 1
Posterior-anterior radiograph of the chest demonstrating elevation of left hemi-diaphragm (black arrow) and left lower lobe consolidation (white arrow).
Image 2
Image 2
Computed tomography coronal image demonstrating marked gaseous distension of the distal cecum, which is flipped cephalad extending into the mid to right upper quadrant (black arrow). Comma sign (white arrow) refers to comma-shaped thickening of the root of the sigmoid mesocolon.
Image 3
Image 3
Computed tomography axial image demonstrating gaseous distension of the cecum (solid white arrow) with visualized air-fluid levels within the bowel (dashed white arrow).
See this image and copyright information in PMC

References

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