3224Hackensack Meridian Health, North Bergen, NJ, USA.
Am Surg. 2022 Aug;88(8):1922-1924. doi: 10.1177/00031348221086817. Epub 2022 Apr 7.
Cecal volvulus can be a rare and challenging diagnosis. We report a 47-year-old female who presented to the hospital and was diagnosed with acute appendicitis based on workup and clinical exam. The patient underwent laparoscopic appendectomy where the appendix was localized after extensive ascending colon mobilization. The patient's post-operative course was complicated by cecal volvulus requiring a right hemicolectomy. There have been several other reported cases of cecal volvulus following laparoscopic appendectomy, both of which also involved considerable cecal mobilization. More data are necessary to determine whether this clinical course could have been prevented with more limited mobilization or with cecopexy at initial surgery. A mobilized cecum may benefit from early surgical intervention to prevent future volvulus or a chronic mobile cecum syndrome. Cecal volvulus should be considered in the case of worsening abdominal pain or obstruction following laparoscopic appendectomy, given the consequences that can result if symptoms are overlooked.
盲肠扭转可能是一种罕见且具有挑战性的诊断。我们报告了一例 47 岁女性患者,因检查和临床检查诊断为急性阑尾炎而就诊。患者接受了腹腔镜阑尾切除术,在广泛的升结肠移位后定位阑尾。患者术后出现盲肠扭转,需要进行右半结肠切除术。已经有几例其他报道的腹腔镜阑尾切除术后盲肠扭转病例,两者都涉及相当大的盲肠移位。需要更多的数据来确定是否可以通过更有限的移动或初始手术时的盲肠固定来防止这种临床过程。移动的盲肠可能受益于早期手术干预,以防止未来的扭转或慢性移动盲肠综合征。如果忽视症状,可能会导致严重的后果,因此在腹腔镜阑尾切除术后出现腹痛或梗阻加重的情况下,应考虑盲肠扭转。