2016, Number 33
Salud Quintana Roo 2016; 9 (33)
Caecum volvulus: Report case
Pacheco-Trujillo E, Acosta-Sánchez A
Full text
Language: Spanish
References: 5
Page: 27-29
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ABSTRACT
Introduction: Colon volvulus is a frequent cause of intestinal obstruction in adults. The most common location of this blockage is sigmoid, followed by cecum. The main mechanism of formation is the clockwise mesenteric edge twisting. The typical clinical presentation corresponds to that of bowel obstructions and the proper medical study for diagnosis is computed tomography.Clinical case: We present the case of an 88 year-old woman with high blood pressure of 5 years of evolution, in treatment with captopril (50 mg/day, 7 days per week) and history of hysterectomy and bilateral salpingo-oophorectomy secondary to unspecified cancer. The patient comes to the Emergency Department of the General Hospital of Chetumal with an 8 day- evolution abdominal pain, located in upper hemiabdomen, with subsequent generalization, puncture-type, high intensity and without radiation, accompanied by nausea and vomiting on multiple occasions of gastrobiliar content that do not improve the picture. We decided to carry out urgent exploratory laparotomy with mesenteric thrombosis or perforated peptic ulcer diagnostic suspicion. The surgical findings were: liquid free cloudy in abdominal cavity, megacolon with handles distended (approximately 20 cm in diameter), volvulus of cecum and pancolonica necrosis, as well as grip ileal bladder.
Conclusion: While colonic volvulus is a frequent cause of bowel obstruction, the location in cecum is unusual, in this case arose as a surgical emergency that prevented complete the diagnostic protocol, without delaying the introduction of surgical treatment for it.
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