Department of Surgery, Al-Thawra Private Hospital, Taiz, Yemen.
Department of Surgery, School of Medicine, University of Kurdistan, Erbil, Iraq.
Pan Afr Med J. 2023 Jan 19;44:37. doi: 10.11604/pamj.2023.44.37.37403. eCollection 2023.
Caecal volvulus is a rare cause of mechanical bowel obstruction (1-1.5%) that carries a high mortality rate if diagnosis or surgical intervention is delayed. We report a 35-year-old man who presented with acute colicky abdominal pain, vomiting, and constipation for the past 18 hours. A plain abdominal X-ray showed distended large bowel loops with two large well-defined air-fluid levels superimposed on each other, suggestive of caecal volvulus. The patient underwent emergency laparotomy, and the intraoperative finding confirmed the diagnosis of gangrenous extended caecal volvulus, which involves the terminal ileum, cecum, and the whole of the ascending colon. A right hemicolectomy was performed, and bowel continuity was restored by primary ileotransverse anastomosis. The patient recovered without complications and was discharged on postoperative day 6. In conclusion, caecal volvulus is a rare cause of adult intestinal obstruction. Early diagnosis and surgical intervention can prevent perforation and reduce morbidity related to volvulus perforation.
盲肠扭转是机械性肠梗阻的罕见病因(1-1.5%),如果诊断或手术干预延迟,死亡率很高。我们报告了一位 35 岁男性,他因急性绞痛性腹痛、呕吐和便秘 18 小时就诊。腹部平片显示扩张的大肠环,有两个大而明确的气液平面相互叠加,提示盲肠扭转。患者接受了紧急剖腹手术,术中发现证实了坏疽性扩展盲肠扭转的诊断,涉及末端回肠、盲肠和整个升结肠。进行了右半结肠切除术,并通过一期回肠横结肠吻合术恢复肠连续性。患者无并发症恢复,术后第 6 天出院。总之,盲肠扭转是成人肠梗阻的罕见病因。早期诊断和手术干预可以预防穿孔,并减少与扭转穿孔相关的发病率。