Khalifa Mohamed Ben, Missaoui Wajdi, Elguedr Wassim, Kbir Ghassen Hamdi, Maatouk Mohamed, Boudokhane Moez
General surgery Department Tahar sfar hospital Mahdia, Faculty of Medicine, University of Monastir Tunisia, Tunisia.
General surgery Department Tahar sfar hospital Mahdia, Faculty of Medicine, University of Monastir Tunisia, Tunisia.
Int J Surg Case Rep. 2025 Apr;129:111160. doi: 10.1016/j.ijscr.2025.111160. Epub 2025 Mar 16.
The complete common mesentery (CCM) is due to a midgut malrotation that occurs during embryonic development. Cecal volvulus (CV) is an uncommon cause of acute intestinal obstruction in this circumstance. The bascule subtype is the rarest form and happens when the cecum folds anteriorly over the ascending colon.
We present two cases of acute intestinal obstruction caused by Cecal Bascule (CB) due to complete common mesentery. Notably, one patient was initially admitted wrongly for a strangulated umbilical hernia and underwent surgery without prior imaging. Both patients had open surgery consisting of a right colectomy with primary intestinal anastomosis with an uneventful recovery.
During fetal development, the intestine rotates counterclockwise around the superior mesenteric artery. The disruption of this process leads to an anomaly called the complete common mesentery, associated with an abnormal fixation and an excessively mobile right colon positioned on the left of the abdomen. This abnormality can be revealed via a cecal volvulus with a bascule subtype, accounting for less than 10 % of all cecal volvulus. Right hemicolectomy with ileocolic anastomosis is the main treatment.
Complete common mesentery is a rare anomaly that can lead to serious complications, including cecal volvulus. Diagnosing this condition via abdominal CT scan can be challenging due to the modified radiological anatomy. Surgeons and radiologists must recognize this pathology. Even less experienced visceral surgeons must be aware and should remain vigilant, as one emergency can hide another.
完全性共同系膜（CCM）是由于胚胎发育过程中发生的中肠旋转不良所致。在这种情况下，盲肠扭转（CV）是急性肠梗阻的罕见原因。拱桥亚型是最罕见的形式，发生于盲肠向前折叠于升结肠之上时。
我们报告两例因完全性共同系膜导致的盲肠拱桥（CB）引起的急性肠梗阻病例。值得注意的是，一名患者最初因绞窄性脐疝被误诊入院，未进行术前影像学检查就接受了手术。两名患者均接受了开放手术，包括右半结肠切除术并一期肠吻合，术后恢复顺利。
在胎儿发育过程中，肠管围绕肠系膜上动脉逆时针旋转。这一过程的中断会导致一种称为完全性共同系膜的异常情况，伴有异常固定以及位于腹部左侧的右半结肠过度活动。这种异常可通过拱桥亚型的盲肠扭转表现出来，占所有盲肠扭转的比例不到10%。右半结肠切除术加回结肠吻合术是主要治疗方法。
完全性共同系膜是一种罕见的异常情况，可导致包括盲肠扭转在内的严重并发症。由于放射解剖结构改变，通过腹部CT扫描诊断这种情况具有挑战性。外科医生和放射科医生必须认识到这种病理情况。即使是经验不足的内脏外科医生也必须有所警觉并保持警惕，因为一种急症可能掩盖另一种急症。
