c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Cecal Volvulus: 1

A D V E R T I S E M E N T

   
 

A 61-year-old patient presented with abdominal pain and a large tender right-sided abdominal mass. Abdominal series showed a distended loop of colon (note haustra). Differential diagnosis included obstructing colon lesion and volvulus.       

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Cecal Volvulus: 2

A D V E R T I S E M E N T

   
 

Barium enema showed a right sided point of complete obstruction. Gravity hydrostatic pressure failed to reduce the obstruction. Colonoscopic reduction was not attempted because of the low probability of reducing a cecal volvulus, the diameter of the colon and risk of perforation. An ileocolic resection was performed.      

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Cecal Volvulus: 3

A D V E R T I S E M E N T

   
 

Volvulus occurs in the parts of the colon with a long mesentery, most commonly sigmoid, followed by cecum and rarely transverse colon. Sigmoid and cecal volvulus can often be differentiated on flat plate by the axis of the dilated loop. Sigmoid is oriented from lower left to upper right and cecum is opposite. Sigmoid volvulus can often be reduced by colonoscopy, allowing elective resection at a later time.      

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This page was last modified on 2/11/2000.