Volvulus of the cecum.

A series of 37 patients with cecal volvulus treated at three different Swedish hospitals during the years 1952-1973 is presented. The symptoms, physical findings and radiologic features are presented. The associated factors found at operation are described and their possible role in provoking torsion is discussed. In 5 patients the idagnosis did not become clear untio autopsy. Thirty-two patients were subjected to operation. The operation consisted of detorsion in 11 cases, cecopexy in 10, cecostomy in 3 and cecopexy plus cecostomy in 3 patients. The remaining 5 patients were subjected to right sided hemicoloectomy. Of these 5 patients one died postoperatively. There were 6 postoperative deaths after other forms of surgery. The survivors were followed, and the mean followup period was 7 years. There was recurrence in only two patients, both treated with cecopexy. The controversial problem of the preferable surgical method is discussed and a review is given of results in series reported during the last 15 years. It was concluded that when the bowel is viable, cecopexy is the treatment of choice while hemicolectomy should be performed in cases with gangrene.