BACKGROUND: Caecal volvulus is a form of intestinal obstruction with life-threatening potential. While rare, it represents a perilous aetiology of intestinal blockage, with clinical manifestations spanning from abdominal discomfort to mortality.
METHODS: We report the cases of three young adults (two males and one female) who presented to the emergency department with different manifestations of severe abdominal pain. All occurred within one month in a tertiary referral centre. Radiological evaluations confirmed the diagnosis of caecal volvulus in all. Subsequently, these individuals underwent right hemicolectomies with end-to-end anastomosis. All experienced an uncomplicated perioperative course.
UNASSIGNED: Caecal volvulus is uncommon, but its yearly incidence is increasing. Early detection and a heightened level of suspicion lead to a timely diagnosis, reducing morbidity and mortality rates.
CONCLUSIONS: We report a case series of caecal volvulus, emphasizing its variable presentation and highlighting the critical importance of an early diagnosis. Typically, patients have a history of similar episodes that resolve without any medical intervention. Definitive treatment involves right hemicolectomy while conservative management is associated with very high recurrence rates. Early detection allows for prompt intervention, resulting in reduced morbidity and mortality rates.

Intestinal malrotation and duplication of the inferior vena cava are rarely diagnosed in adult patients; however, incidence is likely underestimated as they are usually asymptomatic. These congenital malformations have been previously reported in the same patient twice but never with colonic obstruction or ischaemia. A 25-year-old female presented with nausea, vomiting, obstipation, and abdominal pain, and on computed tomography of the abdomen and pelvis was diagnosed with a caecal volvulus and pneumatosis coli associated with intestinal malrotation requiring emergency right hemicolectomy. Incidentally, the patient was noted to have duplication of the inferior vena cava, azygos continuation of the inferior vena cava, and splenic fragmentation. This constellation of symptoms has not been reported in the literature previously. The pattern of malformations follows that of polysplenia syndrome. Although rare, awareness of these malformations can be useful to clinicians.

Caecal volvulus (CV) is an uncommon cause of large intestinal obstruction due to the axial torsion of the caecum, ascending colon, and terminal ileum. We describe the case of a 37-year-old man who presented with bilateral inguinal hernias (the left larger than the right), diffuse abdominal pain, vomiting, difficulty passing stool, and flatus that were comparable to those of an obstructed hernia. Imaging tests revealed a collapsed ascending colon, free fluid collection, and a significantly dilated proximal ileum. An urgent laparotomy showed a perforated, clockwise-twisted caecum that required a right hemicolectomy. Postoperatively, the patient had a good recovery. CV is uncommon, and its symptoms are vague, making diagnosis difficult. For an accurate diagnosis and prompt action, imaging tools and a high index of suspicion are essential. This case serves as a reminder of the significance of taking rare entities into consideration in developing a differential diagnosis of complex abdominal presentations and the necessity for a differential diagnostic approach to choose the most suitable surgical course of action.

UNASSIGNED: The incidence of caecal volvulus (CV) reaches 2.8-7.1 per million per year. CV is a surgical emergency that must be treated immediately because the mortality rate can reach 30 %, and the recurrence rate is 40 %. This study showed a case illustration of caecal volvulus with evidence-based recommendations for indications and management of caecopexy based on postoperative outcomes.
METHODS: 33-Year-old male came with chief complaints of persistent acute abdominal pain one day before hospital admission. Pain is felt suddenly throughout the abdomen. On physical examination, palpable pain in the entire abdomen is obtained, accompanied by the muscular defence with increased bowel sounds. The laboratory only showed increased white blood cells. Abdominal computed tomography (CT) with contrast showed closed-loop obstruction (CLO) signs.
UNASSIGNED: Caecopexy technique use is supported in a case series because it can be done safely, quickly, and without the need to open intestinal segments. Based on previous researches, there were none to low rate of morbidity, mortality, and recurrence. In this patient, caecopexy was carried out and showed good output with no complications.
CONCLUSIONS: Caecopexy is a safe, simple, and less invasive procedure. The advantages of the caecopexy technique are low morbidity, mortality, and recurrence. The patient\'s outcome in this illustration is consistent with other literature. Thus it can be used as evidence-based recommendations in the management of the next case of caecal volvulus.

UNASSIGNED: A common mesentery is defined by the persistence of an embryonic anatomical arrangement secondary to an anomaly of rotation of the primary umbilical loop. Caecal volvulus is a rare cause of intestinal obstruction, which account for 1 to 1.5 % of all intestinal obstructions. A combination of both, intestinal mal rotation and caecal volvulus is rare.
METHODS: We report this rare entity in a 50 year old male with no history of abdominal surgery who was admitted for an acute intestinal obstruction. Clinical examination found a non-complicated right inguinal hernia. Radiological assessment showed signs of an incomplete common mesentery and an important small bowl distention with a transitional zone near the profound inguinal ring. Emergency surgery was performed. Surgical exploration didn\'t find signs of strangulation in the inguinal hernia which motivated midline laparotomy. We discovered a caecal volvulus with an incomplete common mesentery and ischemic lesions in the caecum. Ileocaecal resection was performed with ileocolostomy.
CONCLUSIONS: Common mesentery can be complete or incomplete. It is often well tolerated in adulthood. This intestinal malrotation can sometimes cause serious complications such as volvulus. Their association is rare. Radiology can be very helpful in leading to the diagnosis, but the diagnostic process should not delay surgical intervention which is the basis of the treatment.
CONCLUSIONS: Caecal volvulus is a serious complication of intestinal malrotation. This association is rare in adulthood and symptoms are not specific. Emergency surgery is necessary.

Caecal volvulus is a rare cause of mechanical bowel obstruction (1-1.5%) that carries a high mortality rate if diagnosis or surgical intervention is delayed. We report a 35-year-old man who presented with acute colicky abdominal pain, vomiting, and constipation for the past 18 hours. A plain abdominal X-ray showed distended large bowel loops with two large well-defined air-fluid levels superimposed on each other, suggestive of caecal volvulus. The patient underwent emergency laparotomy, and the intraoperative finding confirmed the diagnosis of gangrenous extended caecal volvulus, which involves the terminal ileum, cecum, and the whole of the ascending colon. A right hemicolectomy was performed, and bowel continuity was restored by primary ileotransverse anastomosis. The patient recovered without complications and was discharged on postoperative day 6. In conclusion, caecal volvulus is a rare cause of adult intestinal obstruction. Early diagnosis and surgical intervention can prevent perforation and reduce morbidity related to volvulus perforation.

Caecal volvulus is an uncommon surgical condition affecting mostly females in their second and third decade of life. It is of vital importance that the general surgeon recognises, resuscitates, diagnoses, and effectively treats these cases in a timely manner to maximise the chance of a positive outcome for the patient. Whilst there are several types of caecal volvulus, the treatment involves, in most cases, surgical intervention. There is a wide variety of surgical interventions that can be performed, ranging from caecopexy or fixation to lateral wall to performing a right hemicolectomy with primary ileocolic anastomosis. There are several factors that influence this decision and can also be based on an individual surgeon\'s expertise and experience. We present a case of a 21-year-old female who presented to our Emergency Department with lower abdominal pain, nausea, and vomiting. She was diagnosed with caecal volvulus with the aid of CT imaging, following which she underwent laparotomy in which caecal volvulus was noted. She underwent appendicectomy and caecopexy and was discharged after an uneventful recovery on post-operative day five and remains well on follow-up.

Caecal volvulus (CV) is a rare cause of intestinal obstruction, defined by an axial torsion of the caecum, ascending colon, and terminal ileum around the mesenteric vascular pedicles, leading to ischemia and bowel necrosis. A 20-year-old woman, with no significant medical history, was admitted for generalized abdominal pain evolving for three days, along with constipation and abdominal distension, but with no vomiting. Physical examination showed a generalized abdominal tenderness with no rigidity or rebound tenderness, associated with abdominal distension and tympanic upon percussion. Laboratory findings were within normal limits. An abdominal computed tomography scan revealed distension of a loop of the large bowel with its long axis extending from the right lower quadrant to the epigastrium or left upper quadrant. Colonic haustral pattern was absent. An abdominal computed tomography scan showed a rounded focal collection of air-distended bowel with haustral creases in the upper left quadrant. In addition, spiraled loops of the collapsed cecum (giving a whirl sign) were noted, along with low-attenuating fatty mesentery from the twisted bowel. The patient underwent an emergency laparotomy and caecectomy using GEA 80 charges. The patient had no complaints post-operation. CV is a rare cause of bowel obstruction, mainly caused by an exceedingly mobile caecum. Despite its rareness, CV represents the second most common cause of large bowel volvulus, behind sigmoid volvulus. For acute obstruction by CV, it is hard to differentiate it clinically from obstruction of the small bowel; therefore, radiological exams are needed. Surgery is the gold standard treatment for CV. We report a rare case of CV to highlight the rarity of this pathology, specify its diagnostic and therapeutic means, and its clinical and biological evolution.

Background Caecal volvulus (CV) is a rare cause of bowel obstruction. However, there has been a steady rise in the number of cases over the decades. The demographic profile of patients developing CV has changed to a much older population. We conducted a retrospective review to determine the incidence, demographic profile, management, and outcomes of CV patients in our institution during the last nine years. Methodology A retrospective audit of all patients diagnosed with CV at Worcestershire Acute Hospitals NHS Trust between 01 January 2011 and 31 March 2020 was performed. Patients admitted with any other type of volvuli such as sigmoid volvulus, small bowel volvulus, and gastric volvulus were excluded. A systematic search of the electronic medical records for all patients admitted under the International Classification of Diseases, Tenth Revision code K562: volvulus was performed for the study duration. It yielded a total of 1,019 patients. After excluding all patients who did not have either a CV or caecal bascule, we included 36 patients in the final analysis. Results Most of our patients were females (78%) with a median age was 76 years. The majority (86%) had at least one medical comorbidity, and 36% had a previous abdominal operation. Abdominal pain was the main complaint in 94% of patients. All patients had undergone a computed tomography (CT) scan to confirm their diagnosis. Most of our patients (84%) underwent surgery. Open right hemicolectomy was the most commonly performed operation (87%). Out of the six patients who did not undergo surgery, three responded to bowel rest and nasogastric tube decompression; one patient underwent successful colonoscopic decompression. In contrast, two patients, unfortunately, passed away. The median length of hospital stay was nine days, with a 30-day mortality of 3%. Conclusions CV remains a rare cause of bowel obstruction. Most of our patients were old, frail, and had medical comorbidities. More than one-third of patients had undergone previous abdominal surgery. Early CT scan followed by right hemicolectomy was associated with low mortality.

Caecal volvulus is a rare cause of intestinal obstruction, of which the caecal bascule is the most uncommonly encountered subtype. Definitive radiological diagnosis of a caecal bascule can be challenging. Lack of familiarity with this rare condition can contribute to delayed diagnosis and treatment, which may result in unnecessary morbidity. This article highlights the case of a patient who presented with a diagnostic challenge, and also discusses the pathogenesis and diagnostic features of caecal bascules. Various options in the surgical management of caecal bascules are reviewed, including the feasibility of laparoscopic-assisted approaches in the emergency setting.