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Case Reports
. 2023 May 22;2023(5):rjad287.
doi: 10.1093/jscr/rjad287. eCollection 2023 May.

Cecal bascule in pregnancy: a case report and review of the literature

Jason Kreinces  1 , Alicia I Robbins  2 , Daniel E Kim  3
Affiliations
Case Reports

Cecal bascule in pregnancy: a case report and review of the literature

Jason Kreinces et al. J Surg Case Rep. .

Abstract

A 36-year-old female at 36 weeks' gestation presented with right upper quadrant abdominal pain. She had no prior surgeries. Her pregnancy had been uncomplicated up until her presentation. Abdominal ultrasound was negative for cholecystitis or cholelithiasis, and the appendix was not visualized. During the second day of her hospital course, an abdominal magnetic resonance imaging (MRI) was performed revealing dilated small intestine with air-fluid levels and an inverted-appearing, prominent cecum. She was urgently taken to the operating room for cesarean section followed by abdominal exploration. After delivery of the child, a cecal bascule was found, with a severely distended cecum. To our knowledge, this is the first report of a cecal bascule diagnosed by MRI, and the first diagnosis of cecal bascule in a pregnant patient requiring surgical intervention. We discuss the pathophysiology, diagnosis and treatment of cecal bascule and review the current literature of reported cases.

Keywords: caecal bascule; colon resection; intestinal obstruction; right hemicolectomy; volvulus.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Axial image of an abdominal MRI on a 36-week pregnant patient with a dilated cecum anteriorly displaced to the ascending colon. Arrows mark the point of inflection.
Figure 2
Figure 2
Coronal image of the same MRI showing a dilated cecum displaced superiorly, consistent with a cecal bascule.
Figure 3
Figure 3
Dilated and deserosalized cecum after reduction of the cecal bascule. The uterus immediately after cesarean section lies to the lower left.
Figure 4
Figure 4
Flow diagram in search for cecal bascule cases associated with pregnancy.
See this image and copyright information in PMC

References

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