術前診断できた盲腸軸捻転症の1例

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  • A CASE OF CECAL VOLVULUS DIAGNOSED BEFORE SURGERY

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We report a case of cecal volvulus diagnosed before surgery. A 74-year-old man seen at another hospital because of ileus was admitted to the hospital for further examination and treatment. An abdominal X-ray and an abdominal computed tomography (CT) suggested volvulus of the right colon, and a colonoscopy revealed obstruction of the ascending colon with taper of the lumen. We found bird's beak sign with a Gastrographin enema from the colonoscope. Under a diagnosis of intestinal obstruction due to cecal volvulus, we performed a laparotomy. During surgery, the cecum was rotated clockwise by 180 degrees around the mesentery, but no necrotic portion was found. Cecopexy between the cecum and pariental peritoneum was carried out following detorsion of the voluvulus. The postoperative course was uneventful. There have been no signs of recurrence as of 28 months after the operation.

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