THREE CASES OF CECAL VOLVULUS

Cecal volvulus is a relative rare disease and it is difficult to diagnose it before laparotomy. Case 1. The patient was a 77-year-old man with chronic respiratory failure who was confined to bed. He was admitted to our hospital because of abdominal pain and fullness. He was diagnosed as having peritonitis of unknown origin. During surgery, the cecum was rotated 180 degrees clockwise and was found to be necrotic. An ileocecal resection was carried out. The postoperative course was uneventful. Case 2. A 69-year-old man was admitted to our hospital with abdominal pain. Plain abdominal X-ray, abdominal CT and a Gastrographin enema findings suggested cecal volvulus, and an emergency operation was carried out. During surgery, the cecum was rotated 180 degrees clockwise but it was not found to be necrotic. Since the patient had a long mobile cecum, cecopexy between the cecum and the parietal peritoneum was carried out following detorsion of the voluvulus. The postoperative course was uneventful. Case 3. A 63-year-old woman was admitted to our hospital with abdominal pain. Definite diagnosis was not established for 2 weeks, when the urinary tract was examined folowing a UGI series via an ileus tube, and emergency operation was carried out. The cecum and ascending colon were necrotic. A right hemicolectomy was carried out. The postoperative course was uneventful.