Camacho-Aguilera José Francisco, Calderón-Vieyra Antonio
Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, México.
Instituto Mexicano del Seguro Social, Hospital General de Zona.
Rev Med Inst Mex Seguro Soc. 2022 Aug 31;60(5):591-598.
Cecal volvulus is a rare disease that causes intestinal obstruction. It has various congenital and acquired risk factors. It is frequently associated with abnormal cecal fixation, and it is caused by torsion of the cecum in one of its three axes. It is not different from other causes of intestinal obstruction, but a delay in its diagnosis can lead to ischemia, necrosis and colon perforation. Its management depends on the viability of the tissues, ranging from untwisting and cecopexy to hemicolectomy with or without anastomosis. We present a case of caecal volvulus (caecal bascule) and review the literature as well.
43-year-old female, who was admitted to an emergency department with data of intestinal obstruction. A simple tomography of the abdomen was performed, where a dilated colon and an image that resembles an inverted coffee bean were identified. An exploratory laparotomy was performed, identifying a bascule-type cecal volvulus, without vascular compromise. Devolvulation, decompression through appendectomy, and caecopexy were performed. After the surgical event, the patient recovered without incident and was discharged with adequate controls by external consultation.
Cecal volvulus is a cause of intestinal obstruction with a low incidence, which is why early recognition and treatment are key to avoiding the complications that its evolution entails. This type of disease should be among our differential diagnoses, since treatment is surgical and delay leads to a high mortality rate.
盲肠扭转是一种导致肠梗阻的罕见疾病。它有多种先天性和后天性危险因素。它常与盲肠固定异常相关,由盲肠在其三个轴之一上扭转引起。它与其他肠梗阻原因并无不同,但诊断延迟可导致缺血、坏死和结肠穿孔。其治疗取决于组织的活力,范围从扭转复位和盲肠固定术到有或无吻合的半结肠切除术。我们报告一例盲肠扭转(盲肠襻式扭转)病例并复习相关文献。
一名43岁女性因肠梗阻数据被收入急诊科。进行了简单的腹部断层扫描,发现结肠扩张以及一个类似倒咖啡豆的影像。进行了剖腹探查术,确定为襻式盲肠扭转,无血管受损。进行了扭转复位、通过阑尾切除术减压以及盲肠固定术。手术后,患者顺利康复,经门诊适当检查后出院。
盲肠扭转是肠梗阻的一个低发病率病因,这就是为什么早期识别和治疗是避免其病情发展所带来并发症的关键。这类疾病应在我们的鉴别诊断范围内,因为治疗是手术治疗,延迟治疗会导致高死亡率。