PDF(Pubmed)
Abstract：
Cecal volvulus is a rare, life-threatening form of bowel obstruction caused by the entanglement of the bowel around the mesenteric axis, compromising blood supply and leading to obstruction and ischemia. The diagnosis is challenging due to its highly variable clinical presentation and differential diagnoses, which may delay timely intervention. This is a case report of an 89-year-old woman who presented with a two-day history of lower right quadrant abdominal pain, nausea, and a temporary loss of consciousness. She also reported a history of chronic constipation. Clinical examination and imaging were suggestive of bowel obstruction, prompting further investigation. Plain radiography and abdominal CT confirmed bowel obstruction, with suspicion of volvulus. The diagnostic uncertainty between cecal and sigmoid volvulus prompted a colonoscopy, which excluded sigmoid volvulus. Emergency laparotomy revealed cecal volvulus and a distended cecum with ischemic changes but without necrosis. A right hemicolectomy was performed, and the patient recovered well postoperatively. This case report aims to expand the medical knowledge around the topic of cecal volvulus. It underscores the challenges in diagnosing and managing this condition and emphasizes the importance of prompt recognition and surgical intervention to improve patient outcomes.
摘要：
盲肠扭转是一种罕见的，由肠系膜轴周围的肠缠结引起的危及生命的肠梗阻形式，损害血液供应并导致阻塞和缺血。由于其高度可变的临床表现和鉴别诊断，诊断具有挑战性。这可能会延迟及时干预。这是一例89岁女性的病例报告，她有两天的右下象限腹痛病史，恶心,暂时失去意识。她还报告了慢性便秘的病史。临床检查和影像学检查考虑肠梗阻，促使进一步调查。X线平片和腹部CT证实肠梗阻，怀疑有扭转.盲肠和乙状结肠扭转之间的诊断不确定性促使结肠镜检查，排除乙状结肠扭转.紧急剖腹手术显示盲肠扭转和盲肠扩张，伴有缺血性改变，但无坏死。进行了右半结肠切除术,患者术后恢复良好。本病例报告旨在扩大盲肠扭转的医学知识。它强调了诊断和管理这种情况的挑战，并强调了及时识别和手术干预以改善患者预后的重要性。
