Cecal volvulus

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Abstract
The case records of 12 patients with cecal volvulus over a 20-yr period were reviewed. The patients averaged 46.7 yr old; 75% were white and 67% were male. Patients presented with signs and symptoms of intestinal obstruction. Pain and distention were present in more than half of the patients. X-rays assisted in making the diagnosis of cecal volvulus in only 5 of the patients. Diagnosis was made in the remainder at the time of surgical exploration. At operation, 1 cecum was necrotic and required resection. Five patients underwent cecostomy, 2 cecopexy, and 4 simple detorsion. Post-operatively, 1 patient developed a wound infection. There were no deaths. Follow-up for 7 patients averaged 75 mo. each. One patient who had undergone simple detorsion developed another cecal volvulus. All who were contacted were alive and well. Cecal volvulus generally occurs in middle-aged white males. Cecostomy or cecopexy adequately treats cecal volvulus when the cecum remains viable. Prompt surgical intervention, before strangulation of the colon occurs, results in low mortality even in city hospital patients.

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