A case of cecal volvulus in a cerebral palsy patient: Usefulness of multidetector computed tomography for preoperative diagnosis

A 39-year-old man, bedridden because of cerebral palsy, was admitted to our hospital with abdominal distension and polypnea. Emergent dynamic computed tomography (CT) revealed markedly distended bowel with air-fluid levels in the lower abdomen, confirmed to be the cecum by following the bowel loops in a retrograde fashion from the rectum. So-called "bird beak" and "whirl" signs were observed on the coronal reconstruction image. On the basis of these CT findings, cecal volvulus was suspected and emergent surgery was performed. Laparotomy revealed a 180 degrees clockwise rotation of the ileocecal portion of the colon around the ileocecal mesentery. The patient was successfully treated by surgical intervention with no complications. Volvulus of the cecum is a rare but important cause of acute abdomen and is associated with a high mortality rate. Multidetector CT is considered fundamental in the prompt and accurate diagnosis of this condition.