[Caecal volvulus: presentation of 18 cases and review of literature].

INTRODUCTION

Caecal volvulus is the second most frequent location of colonic volvulus after sigmoid colon. It usually shows up as bowel obstruction. MATERIAL Y METHOD: We review our experience of 18 cases of cecal volvulus treated in our centre between 1987 and 2007.

RESULTS

We studied 8 males (44.4%) and 10 females (55.6%), with a mean age of 63.3 years. As an associated factor it was noted that 10 patients (55.6%) were bedridden. The most common clinical signs were abdominal distension and tenderness, constipation and vomiting. Simple abdominal X-rays have a low diagnostic accuracy, though they reveal a bowel obstruction. Only 1 patient underwent elective surgery. In 10 patients (55.6%) a right hemicolectomy was performed, in 3 (16.8%) cecostomy, in 3 cecopexy and in 2 (11.2%) devolvulation only. There were complications in 3 patients (16.8%), 2 prolonged ileus and 1 wound infection. There were no recurrences.

CONCLUSIONS

Caecal volvulus is an emergency pathology, requiring surgical treatment. Right hemicolectomy is the treatment of choice both in viable and gangrenous colon. Caecostomy is an alternative treatment in the high risk patient with a viable colon.