34 Caecal volvulus
Fig. 34.1 This patient has a gas-filled caecum pointing towards the left upper quadrant of the abdomen. This is a caecal volvulus. (With thanks to Dr Maruti Kumaran for kindly providing this image.)
Background
Caecal volvulus is a rare but important condition, as it carries a high mortality rate.
It is caused by twisting of the caecum, which is often abnormally mobile in these patients, on its mesentery. The ascending colon is normally fixed and retroperitoneal. This leads to a closed loop obstruction, and rapid vascular compromise with resulting ischaemia and infarction.
Clinical features
There is acute colicky abdominal pain, and signs and symptoms of intestinal obstruction.
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