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J Emerg Med 2020 Mar 13;58(3):e117-e120. Epub 2019 Dec 13.

Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan.

Background: Portal venous gas has mainly been studied in pediatrics and seen in cases of necrotizing enterocolitis. It is a rare finding in adults and is typically associated with underlying intestinal ischemia or other malignant intra-abdominal pathology. Portal venous gas is seen more readily on ultrasound compared to radiographs in both pediatric and adult patients. Read More

Ann Med Surg (Lond) 2019 Dec 31;48:69-72. Epub 2019 Oct 31.

Department of General and Visceral Surgery, Hassan II University Hospital of Fez, 30050, Fez, Morocco.

Introduction: Cecal volvulus is an uncommon cause of intestinal obstruction due to an axial twist of the caecum, ascending colon and terminal ileum around the mesenteric pedicle. It is responsible for 1%-1.5 of all intestinal obstructions in adult. Read More

Gan To Kagaku Ryoho 2019 Oct;46(10):1659-1661

Dept. of Surgery, Yokohama City University.

A 52-year-old man whose fecal occult blood test was positive was found to have type 2 sigmoid colon cancer by colonoscopy. On enhanced barium enema study, the cecum was in the pelvis, and the ascending colon was running medially in the abdomen. Enhanced CT scan of the abdomen revealed rotation of the superior mesenteric vein(SMV). Read More

Ann Emerg Med 2019 10;74(4):491-508

Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.

Ann R Coll Surg Engl 2020 Feb 18;102(2):e39-e41. Epub 2019 Sep 18.

General Surgery Directorate, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.

Approximately 5% of intestinal obstruction cases are caused by internal herniation. Caecal herniation through the foramen of Winslow is considered a rare event. The management of caecal herniation remains challenging due to the lack of literature highlighting this pathology. Read More

Open Access Maced J Med Sci 2019 Jul 12;7(13):2150-2153. Epub 2019 Jul 12.

Division of General Surgery, Carlo Urbani Hospital, Jesi, Italy.

Background: Caecum volvulus (CV) is defined as an axial twisting that causes an inversion position of the caecum, ascending colon and terminal ileum. This anatomical finding is responsible for some clinical features. Obstruction and strangulation are the most important and life-threatening. Read More

J Nippon Med Sch 2019 ;86(3):183-186

Department of Surgery, Nippon Medical School.

The preoperative diagnosis of cecal volvulus (CV) is rare and difficult and emergent laparotomy is frequently performed. Here, we report a case of CV that was diagnosed by preoperative computed tomography in a patient with an intellectual disability. In addition, we demonstrate that elective laparoscopic cecopexy can be performed following conservative treatment, such as the use of an ileus tube per anus. Read More

Radiol Case Rep 2019 Jun 27;14(6):697-699. Epub 2019 Mar 27.

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.

Cecal bascule is a unique form of large bowel volvulus in which the cecum folds anterior to the ascending colon and generates a flap valve which impairs cecal emptying and results in cecal dilation [1]. Presenting symptoms include nausea, vomiting, abdominal pain, distension, and constipation. We report a case of a 74-year-old male who developed abdominal pain and nausea after a coronary artery bypass graft surgery. Read More

Cir Cir 2019 ;87(2):211-214

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España.

Atraumatic splenic rupture, an infrequent surgical emergency, constitutes a life-threatening situation. The lack of a traumatic background makes it difficult to suspect. We present a case of a 45-year-old woman, with history of bariatric surgery, referred to our emergency due to 3 weeks long abdominal and lumbar pain, in shock. Read More

BMJ Case Rep 2019 Jan 28;12(1). Epub 2019 Jan 28.

Colorectal Surgery, Saint George Hospital, Kogarah, New South Wales, Australia.

Large-bowel obstruction caused by volvulus is potentially life threatening if not managed promptly. Sigmoid colon is the most common site of volvulus followed by caecum. Synchronous double colonic volvulus is an exceedingly rare entity, with only five cases published previously. Read More

Am Surg 2018 Sep;84(9):e418-e419

Am J Case Rep 2018 Nov 15;19:1362-1365. Epub 2018 Nov 15.

Department of General Surgery, Mount Lebanon Hospital, Beirut, Lebanon.

BACKGROUND Bowel obstruction is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Intestinal malrotation is one of the rarest causes of mechanical bowel obstruction. In adults, the incidence rate is 0. Read More

Pan Afr Med J 2018 15;29:154. Epub 2018 Mar 15.

University of Botswana, Department of Library Services, Gaborone, Botswana.

Congenital intestinal malrotation is a gastrointestinal anomaly whose most serious complication is midgut volvulus. More commonly, it presents as an incidental finding at laparotomy, or as a finding on diagnostic imaging (Ultrasound, CT, Upper GI contrast study). Most patients are diagnosed in childhood. Read More

Turk J Gastroenterol 2018 03;29(2):221-225

Pediatric Digestive and Hepatic Research Center, Zabol University of Medical Sciences, Zabol, Iran; Clinical Research Development Unit, Zabol University of Medical Sciences, Amir-Al-Momenin Hospital, Zabol, Iran.

Cases of colonic volvulus in children are infrequently described in the literature. Here we describe the case of three patients with colonic volvulus. The first patient was a 10-year-old girl with abdominal dilation and pain and no bowel movement for 48 h. Read More

J Coll Physicians Surg Pak 2018 Apr;28(4):317-319

Department of Orthopedic Surgery, Combined Military Hospital, Rawalpindi.

We present a case of 14-year girl with left-sided acute appendicitis who presented with lower abdominal pain. Midgut malrotation occurs at a rate of 1 in 500 live births. The condition is incidentally diagnosed during various radiological investigations done for other purposes. Read More

Gastroenterology 2018 07 1;155(1):e20-e21. Epub 2018 Feb 1.

Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, East Carolina University, Greenville, North Carolina.

Vet Radiol Ultrasound 2018 May 23;59(3):272-278. Epub 2018 Jan 23.

Department of Molecular Biomedical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27607, USA.

Colonic torsion is a life-threatening condition in dogs and radiographic findings for this condition have not been well described. The purpose of this retrospective case series was to describe radiographic findings and clinical signs in a group of dogs with colonic torsion. Inclusion criteria were dogs presenting during the period of 2006 and 2016, and that had abdominal radiography and a surgically confirmed or presumed diagnosis of colonic torsion. Read More

Asian J Endosc Surg 2018 Nov 11;11(4):402-404. Epub 2018 Jan 11.

Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

We herein report a case of cecal volvulus successfully treated with endoscopic colopexy. A 73-year-old man with a high fever and abdominal fullness was diagnosed with ileus caused by cecal volvulus. CT showed a dilated cecum and small intestine without bowel strangulation as well as acute pneumonia. Read More

Medicine (Baltimore) 2017 Dec;96(49):e8599

aDepartment of SurgerybDepartment of Gastroenterology, SUNY Stony Brook, Stony Brook, NY.

Rationale: Heterotaxy with polysplenia is an extremely rare congenital condition resulting from abnormal arrangement of organs in the abdominal and thoracic cavities during embryologic development. When a malignancy such as pancreatic cancer develops under these conditions, surgical resection becomes particularly complex. This case report demonstrates successful pancreatic cancer resection despite the patient's complicated anatomy. Read More

BMJ Case Rep 2017 Oct 15;2017. Epub 2017 Oct 15.

Pediatric Surgery, Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India.

Intern Med 2017 Oct 15;56(20):2791-2796. Epub 2017 Sep 15.

Department of Gastroenterology, Fukuoka Tokushukai Medical Center, Japan.

Ehlers-Danlos syndrome, hypermobility type (EDS-HT) is unexpectedly common and is associated with a high rate of gastrointestinal manifestations. We herein report the first documented case of mobile cecum associated with EDS-HT. A 21-year-old woman with repeated right lower abdominal pain was initially diagnosed with EDS-HT. Read More

AJR Am J Roentgenol 2017 Oct 4;209(4):762-766. Epub 2017 Aug 4.

1 Department of Radiology, NYU Langone Medical Center, 660 First Ave, 3rd Fl, New York, NY 10016.

Objective: The objective of our study was to assess the utility of CT features in the diagnosis of cecal volvulus.

Materials And Methods: Forty-three patients undergoing CT for cecal volvulus and with surgical or clinical follow-up were included. Two radiologists (11 years and 1 year of experience) evaluated CT examinations for the following: whirl sign, abnormal cecal position, "bird beak" sign, severe cecal distention, mesenteric engorgement, a newly described "central appendix" sign (defined as abnormal appendix position near midline), and overall impression for cecal volvulus. Read More

BMJ Case Rep 2017 Jul 27;2017. Epub 2017 Jul 27.

Department of Radiology, Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, UK.

The aim of this report is to discuss with high-quality images, a case of a caecal volvulus herniating through the foramen of Winslow with signs of perforation. Read More

Am Surg 2017 Jun;83(6):e200-201

Pediatr Radiol 2017 Oct 16;47(11):1477-1482. Epub 2017 Jun 16.

Department of Diagnostic Radiology, Montefiore Medical Center, 111 E. 210th St, Bronx, NY, 10467, USA.

Background: Anatomical imaging findings indicating normal bowel rotation can be identified on cross-sectional imaging, including magnetic resonance imaging (MRI) performed for non-related indications.

Objective: The goal of our study was to assess whether non-targeted MRI can accurately assess intestinal malrotation.

Materials And Methods: Four anatomical landmarks were assessed on MRIs of the chest, spine or abdomen performed from January 2006 to June 2014, on patients who also had upper gastrointestinal series (UGI) performed within 10 years of the MRI date: 1) retroperitoneal duodenum, 2) left upper quadrant duodenojejunal junction, 3) superior mesenteric artery to the left of the superior mesenteric vein, and 4) right lower quadrant cecum. Read More

Pan Afr Med J 2016 30;25:55. Epub 2016 Sep 30.

Service de Radiologie et Imagerie Médicale, CHU Aristide Le Dantec, BP 3001 Pasteur Dakar, Sénégal.

We report the case of a 7-year old patient presenting for acute paroxysmal abdominal pain at the level of epigastrium associated with vomiting without involving blockage of materials and gas. Clinical examination and laboratory tests were unremarkable. Abdominal ultrasound was requested as a first line investigationa and showed a right echogenic homogeneous flank and iliac fossa mass with regular contours without vascular Doppler signal and associated with "whirl sign" of mesenteric vessels. Read More

Pediatr Radiol 2017 Apr 28;47(4):404-410. Epub 2017 Feb 28.

Department of Radiology and Imaging Sciences, Riley Hospital for Children, 702 Barnhill Drive, Rm. 1053, Indianapolis, IN, 46202, USA.

Background: Colonic volvulus is rare in children and associated with colonic dysmotility. Diagnosis of colonic volvulus on radiographs in these patients can be challenging. The purpose of the study was to identify the accuracy of abdominal radiographs and findings suggestive of colonic volvulus. Read More

Am Surg 2016 Nov;82(11):303-304

Department of Surgery, Cox Monett Hospital, Monett, Missouri, USA.

J Pediatr Surg 2017 Jun 2;52(6):1062-1066. Epub 2017 Feb 2.

Department of Pediatric Surgery, Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA.

Background/purpose: Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis. Read More

Gastroenterology 2017 Feb 3;152(3):486-487. Epub 2017 Jan 3.

Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts.

JSLS 2016 Oct-Dec;20(4)

Department of Internal Medicine, Therezinha de Jesus University Hospital, Faculty of Medical and Health Sciences of Juiz de Fora (SUPREMA), Minas Gerais, Brazil.

Background And Objectives: The mobile cecum is an embryologic abnormality and has been associated with functional colon disease (chronic constipation and irritable bowel syndrome). However, unlike functional disease, the primary treatment is operative, using laparoscopic cecopexy. We compare the epidemiology and pathophysiology of mobile cecum syndrome and functional colon disease and propose diagnostic and treatment guidelines. Read More

BMJ Case Rep 2016 Oct 14;2016. Epub 2016 Oct 14.

Department of Clinical Surgical Sciences, University of West Indies, St Augustine, Trinidad, San Fernando, Trinidad and Tobago.

Colonic volvulus usually occurs as a single event that can affect various parts of the colon. The usual sites affected being the sigmoid colon (75%) and the caecum (22%). The phenomenon of multiple sites simultaneously undergoing volvulus is an extremely rare occurrence. Read More

J Nippon Med Sch 2016 ;83(4):172-6

Department of Surgery, Nippon Medical School.

Cecal volvulus is characterized by torsion of the cecum around its own mesentery. However, cecal volvulus rarely develops soon after elective laparoscopic cholecystectomy. We report on a case of cecal volvulus that developed in a 54-year-old women 1 day after elective laparoscopic cholecystectomy and was successfully treated via colonoscopic decompression. Read More

Rozhl Chir Summer 2016;95(7):291-3

Unlabelled: Internal abdominal hernias present an infrequent surgical diagnosis and are usually encountered accidentally during surgery. They are generally considered as an extremely rare cause of ileus. In our article we present the case of a 69-year-old healthy female who was operated for suspected gastric volvulus as suggested by the CT scan; however, upon surgery, herniation of the right-sided colon into the omental bursa with subsequent cecal dilation and bowel wall necrosis was revealed to be the true culprit. Read More

Diagn Interv Imaging 2017 Mar;98(3):273-275

Department of Radiology, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France. Electronic address:

Ann R Coll Surg Engl 2016 Sep 8;98(7):e138-40. Epub 2016 Jun 8.

Royal Gwent Hospital , Newport , UK.

Introduction Malrotation of the midgut and appendiceal mucocoele are both extremely rare pathological conditions in adults. To our knowledge, there are only two reported cases in the English literature with a combination of both conditions. Case History A 65-year-old man presented with a 10-day history of upper abdominal pain associated with abdominal bloating and weight loss. Read More

Cir Cir 2017 Jan - Feb;85(1):87-92. Epub 2016 Apr 28.

Hospital Ángeles del Pedregal, Ciudad de México, México.

Background: Caecal volvulus is an uncommon cause of intestinal obstruction. Its clinical presentation is non-specific, with the diagnosis usually confirmed by barium enema and abdominal computed tomography. Treatment depends on many factors, and minimally invasive approaches are becoming the treatment of choice. Read More

BMJ 2016 Mar 22;352:i1382. Epub 2016 Mar 22.

1 Eastbourne, ESHT, Eastbourne, UK2 Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne, UK.

BMJ Case Rep 2016 Jan 18;2016. Epub 2016 Jan 18.

Department of Clinical Surgical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago.

Colonic volvulus involving the caecum and splenic flexure of the colon is an extremely rare surgical entity and, as a result, it is rarely entertained as a differential diagnosis for large bowel obstruction. The most common site of volvulus is located at the sigmoid colon (75%) followed by caecum (22%). Rare sites of colonic volvulus include the transverse colon (about 2%) and splenic flexure (1-2%). Read More

Cir Cir 2016 Nov - Dec;84(6):513-517. Epub 2015 Dec 11.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Infanta Leonor, Madrid, España.

Background: Caecal bascule is an infrequent type of caecal volvulus. It appears when the caecum folds upon itself, causing an intestinal obstruction. It is usually diagnosed using imaging techniques or intra-operatively. Read More

Ugeskr Laeger 2015 Sep;177(39):V04150346

This case presents a synchronous sigmoid- and caecum volvulus in a 69-year old man with Parkinson's disease, hypertension and previous history of colonic volvulus. On admission the patient had abdominal pain, nausea, vomiting and constipation. The CT scan showed a sigmoid volvulus with a dilated caecum. Read More

Am J Case Rep 2015 Aug 27;16:574-6. Epub 2015 Aug 27.

Department of General Surgery, Konya State Hospital, Konya, Turkey.

Background: In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children.

Case Report: We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. Read More

Surg Obes Relat Dis 2015 Sep-Oct;11(5):e43-5. Epub 2015 Jun 15.

Department of Surgery, Division of Acute Care Emergency Surgery at the University of Maryland Medical Center, Baltimore, Maryland.

Emerg Med Australas 2015 Oct 19;27(5):489-91. Epub 2015 Jul 19.

Department of Surgery, Canterbury Hospital, Canterbury, New South Wales, Australia.

BMJ Case Rep 2015 Apr 28;2015. Epub 2015 Apr 28.

Department of General Surgery, Hospital La Mancha Centro, Alcázar de San Juan, Spain.

Int J Surg Case Rep 2015 12;10:25-9. Epub 2015 Mar 12.

Department of Surgery, Tulare Regional Medical Center, CA 93274, USA.

Introduction: Colonic volvulus is the third leading cause of the colonic obstruction with cecal volvulus accounting for approximately 40% of all colonic volvulus. Lack of peritonealization of the right colon, adhesions from prior surgery, colonic atony, and distal colonic obstruction are potential risks factors for the development of cecal volvulus.

Prersentation Of The Case: 63 year old male with history of multiple prior intraabdominal surgeries and recurrent ventral hernia. Read More

Praxis (Bern 1994) 2014 Dec;103(25):1501-2

Klinik für Allgemein-, Viszeral-, Gefässchirurgie, Departement Chirurgie, Kantonsspital Baden.

BMJ Case Rep 2014 Dec 8;2014. Epub 2014 Dec 8.

PCMD, Torbay Hospital, UK.

JBR-BTR 2014 May-Jun;97(3):180-1