盲腸軸捻転症の1例

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  • A CASE OF CECAL VOLVULUS

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A 43-year-old woman was admitted to the center because of sudden abdominal pain and abdominal distention. Plain X-ray films of the abdomen showed comma-shaped, markedly distended bowel, suggestive of the sigmoid colon, in the left lower quadrant. Barium enema demonstrated an abrupt cut-off and the bird beak sign in the sigmoid colon. Preoperative diagnosis of sigmoid volvulus was made and emergency laparotomy was performed. No abnormalities were found on the sigmoid colon. The cecum was markedly distended and counter-clockwise cecal twisting by 360 degrees around the first portion of the ascending colon was observed. Definite diagnosis of a cecal volvulus was established. Since the patient had a long mobile cecum, was made cecopexy between the cecum and parietal peritoneum was following detorsion of the volvulus. The post-operative course was uneventful and she has been having no recurrence after the operation. Cecal volvulus is a relatively rare disease, therefore the correct preoperative diagnosis is difficult. Given the cecum was viable, cecopexy was a proper choice of treatment.

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