Acute caecal volvulus: report of 22 cases and review of literature.

The management of 22 patients with acute caecal volvulus is described along with a review of literature. The preoperative diagnosis of caecal volvulus was made in 60 percent of the cases based on clinical findings and plain abdominal roentgenograms. Eleven patients had signs of peritonitis either due to gangrene or perforation of the caecum. On laparotomy all patients had mobile caecum but precipitating factors were not evident in any patient. The authors recommend resection and primary end-to-end ileocolic anastomosis in the presence of gangrene or perforation of the caecum. In non-complicated cases of caecal volvulus, detorsion and caecopexy are preferable because of low mortality, morbidity and recurrence rates.