Caecal volvulus and jejunostomy: challenging diagnostic

Morera-Grau, Álex; Membrilla Fernández, Estela; González Castillo, Ana María; Pelegrina Manzano, Amalia; Guerrero-Ortiz, M. A.; Téllez-Marquès, C.; Pons Fragero, María José; Guzmán-Ahumada, J.; Pera Roman, Miguel; Sancho Insenser, Juan

doi:http://dx.doi.org/10.1093/jscr/rjab148

Caecal volvulus and jejunostomy: challenging diagnostic

License

Citation

Morera-Grau A, Membrilla-Fernández E, González-Castillo AM, Pelegrina-Manzano A, Guerrero-Ortiz MA, Téllez-Marquès C, Pons-Fraguero MJ, Guzmán-Ahumada J, Pera-Román M, Sancho-Insenser JJ. Caecal volvulus and jejunostomy: challenging diagnostic. J Surg Case Rep. 2021;2021(4):rjab148. DOI: 10.1093/jscr/rjab148

Abstract

Caecal volvulus represent the 20-40% of colonic volvulus, being the second most frequent localization. It causes intestinal occlusion symptomatology (nausea, vomiting, abdominal distension). We present a case of 45-year-old women with feeding jejunostomy tube due to connatal anoxia. She arrives at A&E after 12 h of vomits and abdominal pain. The CT scan shows a small intestine dilation that suggested a small intestine volvulus. A laparotomy is performed showing a caecal volvulus, so ileo-cequectomy with primary anastomosis is performed. After several complications, she was discharged after 60 days of hospital stay. Caecal volvulus can be challenging to diagnose by clinic, because it can be hardly differenced from other intestinal occlusion causes. CT scan can be useful to reach the diagnostic and see signs of tissue suffering. In contrast with sigma volvulus, endoscopic treatment has not shown any benefit to solve it.