[Intermittent cecal volvulus. Report of 2 cases].

In our country, acute cecal volvulus is responsible of 3.3% of mechanical large bowel obstructions. More than half of these cases have a history compatible with intermittent cecal volvulus, an usually overlooked diagnosis. The author reports two cases of intermittent cecal volvulus, treated in the last ten years. Both patients are female, aged 45 and 71 years old, with a history of 3 and 5 years of recurrent abdominal distention located in the right lower quadrant, that relieves spontaneously after the expulsion of gases or defecation. The symptomatology of the first cases was erroneously attributed to a concomitant colonic diverticulosis and the patient was subjected to a elective sigmoidectomy. The right colon and cecum was observed located in the right lower quadrant during the operation, and an appendectomy and a tube cecostomy for cecopexia were performed. The postoperative evolution was uneventful, and the patient is asymptomatic nine years later. The diagnosis in the second case was performed with a barium enema and a cecostomy for cecopexia was performed. The patient is asymptomatic two years later. The anatomical prerequisite for this condition is a lack of fusion of ascending colon to parietal peritoneum, which allows free rotation of this segment. The diagnosis must be suspected in patients with chronic and recurrent abdominal distention and must be confirmed with a barium enema. The surgical treatment consist in the fixation of the ascending colon.