Bhatti Samiullah, Khan Mahmood Ayyaz, Farooka Waris, Butt Usman Ismat, Rehman Usman Ali, Malik Awais Amjad
Surgical Unit 2, Services Hospital, Lahore.
J Coll Physicians Surg Pak. 2017 Mar;27(3):S18-S20.
Caecal volvulus is a rare cause of intestinal obstruction. Caecal volvulus precipitated by acute appendicitis is even rarer. We report an unusual case of caecal volvulus with acute appendicitis as a cause. A 55-year female presented in surgical emergency with 3 days history of abdominal pain, distension and absolute constipation; and 2 days history of vomiting. Her past surgical history was significant for hysterectomy 5 years back. On examination, abdomen was distended and bowel sounds exaggerated. X-ray abdomen erect showed a single large air fluid level in the right hemiabdomen. A preoperative diagnosis of intestinal obstruction due to adhesions was made and patient prepared for exploratory laparotomy. On exploration, a huge caecum was lying in the midline and was twisted around a band arising from the appendix and attached deep into the pelvis. The appendix was densely inflammed. The volvulus was de-twisted in a counter clockwise manner. Viability of the caecum was confirmed and appendectomy was done. Caecopexy was performed and abdomen was closed. Postoperative recovery of the patient was uneventful and she was safely discharged on 5th postoperative day.
盲肠扭转是肠梗阻的罕见病因。由急性阑尾炎引发的盲肠扭转更为罕见。我们报告一例以急性阑尾炎为病因的不寻常盲肠扭转病例。一名55岁女性因腹痛、腹胀和完全性便秘3天，呕吐2天而入院接受外科急诊治疗。她既往有5年前子宫切除术史。检查时，腹部膨隆，肠鸣音亢进。腹部立位X线片显示右半腹有一个大的气液平面。术前诊断为粘连性肠梗阻，并为患者准备了剖腹探查术。术中发现一个巨大的盲肠位于中线，围绕着一条从阑尾发出并附着于盆腔深处的索带扭转。阑尾重度发炎。以逆时针方向将扭转复位。确认盲肠活力后行阑尾切除术。进行了盲肠固定术，然后关闭腹腔。患者术后恢复顺利，术后第5天安全出院。
