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Case Reports
. 2023 May 31;15(5):e39761.
doi: 10.7759/cureus.39761. eCollection 2023 May.

Intestinal Nonrotation and Cecal Volvulus: A Unique Combination of Rare Pathologies

Tatiana Fernandez Trokhimtchouk  1 , Luis F Flores  1 , Álvaro Morillo Cox  1 , Alberto Gordillo  2 , Joseline K Crespo Martinez  1
Affiliations
Case Reports

Intestinal Nonrotation and Cecal Volvulus: A Unique Combination of Rare Pathologies

Tatiana Fernandez Trokhimtchouk et al. Cureus. .

Abstract

Intestinal nonrotation and cecal volvulus are rare clinical entities, and their coexistence is exceptionally uncommon. We present a case of a 41-year-old male patient with symptomatic intestinal nonrotation and associated cecal volvulus. Diagnostic imaging played a crucial role in recognizing the conditions and guiding surgical intervention. The patient underwent laparotomy and right hemicolectomy with a favorable postoperative course. This case highlights the challenges in diagnosing and managing these rare conditions. Further studies are needed to optimize the management strategies for this unique combination of pathologies.

Keywords: hemicolectomy; intestinal obstruction; intestinal volvulus; laparotomy; volvulus of midgut.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. (A) Abdominal distention on physical examination. A plain radiograph (B) on the decubitus position, with a markedly dilated cecum located in the left hemiabdomen, (C) In the erect position with fluid levels present.
Figure 2
Figure 2. Abdominal contrast-enhanced CT. (A) Axial view in the arterial phase, the cecum is dilated (measured at 10.6 cm) in the left hypochondrium. (B) Sagittal view where the twisting of the mesentery is visible (yellow arrow). (C) Coronal view with congestion of the mesentery and fat stranding.
Figure 3
Figure 3. Abdominal contrast enhanced CT in axial (A) and coronal (B) views showing reversed relationship of the SMA (red arrow) and SMV (blue arrow), a pathognomonic sign of intestinal nonrotation.
Figure 4
Figure 4. (A) Transoperative photograph of the volvulated cecum. (B) Resected surgical specimen.
See this image and copyright information in PMC

References

    1. Steele SR, Hull TL, Hyman N, et al. London: Springer eBooks; 2016. The ASCRS Textbook of Colon and Rectal Surgery.
    1. Presentation of intestinal malrotation and midgut volvulus in adults: case report & literature review. Dehaini H, Nasser Eldine R, Doughan S, Khalifeh M, Khasawneh H, Hussain H, Sbaity E. Int J Surg Case Rep. 2020;73:27–30. - PMC - PubMed
    1. Variations of intestinal malrotation in adults: a case report of midgut volvulus and literature review for the surgeon. Ribeiro T, Greene B, Bennett S, Msallak H, Karanicolas P. Int J Surg Case Rep. 2022;91:106750. - PMC - PubMed
    1. Intestinal malrotation in adolescents and adults: spectrum of clinical and imaging features. Pickhardt PJ, Bhalla S. AJR Am J Roentgenol. 2002;179:1429–1435. - PubMed
    1. Rare presentation of acute intestinal obstruction: cecal volvulus with malrotation. Pramod S, Kumar GK. J Case Reports. 2019;9:33–35.

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