Ahmed Mays, Halabi Mouhammad, Khoury Kayanne, Moussa Hatem
The Department of Surgery, American Hospital in Dubai, United Arab Emirates.
School of Medicine, Royal College of Surgeons Ireland - Bahrain, Kingdom of Bahrain.
Int J Surg Case Rep. 2025 Jan;126:110543. doi: 10.1016/j.ijscr.2024.110543. Epub 2024 Nov 2.
Cecal volvulus is an uncommon cause of large bowel obstruction that typically presents in older adults with a history of chronic constipation or prior abdominal surgery. However, this report documents a rare and atypical case of cecal volvulus presenting in a middle-aged female with no significant past medical or surgical history. This case also highlights the benefits of adopting a synergistic approach between a physician's clinical judgment and the patient's presentation when making a diagnosis to ensure timely interventions and prevent life-threatening complications.
A 40-year-old female with no significant medical or surgical history presented to the emergency department with acute onset of severe abdominal pain radiating to the lower back, associated with nausea, vomiting, and constipation. CT imaging revealed a markedly distended cecum with evidence of volvulus. Despite the absence of common predisposing factors of cecal volvulus, the patient was correctly diagnosed. She underwent an urgent right hemicolectomy with primary anastomosis, which was uneventful. The patient had a complete recovery and was discharged home on postoperative day 5.
This case is particularly noteworthy due to the patient's atypical demographic profile and the absence of common risk factors associated with cecal volvulus. The timely recognition and surgical intervention were critical in preventing severe complications such as bowel ischemia or perforation. Furthermore, this case underscores the importance of considering cecal volvulus in the differential diagnosis of acute abdominal pain, even in patients who do not exhibit conventional risk factors.
This case report highlights a rare presentation of cecal volvulus in a previously healthy middle-aged woman, emphasizing the importance of prompt diagnosis and intervention. The favorable outcome in this patient demonstrates the critical role of timely surgical management in such high risk cases.
盲肠扭转是大肠梗阻的一种罕见病因，通常见于有慢性便秘病史或既往腹部手术史的老年人。然而，本报告记录了一例罕见的非典型盲肠扭转病例，患者为一名中年女性，既往无重大内科或外科病史。该病例还凸显了在诊断时采用医生临床判断与患者表现相结合的协同方法的益处，以确保及时干预并预防危及生命的并发症。
一名40岁女性，无重大内科或外科病史，因突发严重腹痛并放射至下背部，伴有恶心、呕吐和便秘，就诊于急诊科。CT成像显示盲肠明显扩张并有扭转迹象。尽管该患者没有盲肠扭转常见的诱发因素，但仍被正确诊断。她接受了紧急右半结肠切除术并一期吻合，手术过程顺利。患者完全康复，术后第5天出院。
该病例特别值得注意，因为患者的人口统计学特征不典型，且缺乏与盲肠扭转相关的常见风险因素。及时识别和手术干预对于预防诸如肠缺血或穿孔等严重并发症至关重要。此外，该病例强调了即使在没有传统风险因素的患者中，在急性腹痛的鉴别诊断中考虑盲肠扭转的重要性。
本病例报告突出了一名此前健康的中年女性罕见的盲肠扭转表现，强调了及时诊断和干预的重要性。该患者的良好预后证明了在这类高风险病例中及时手术管理的关键作用。
