Document Detail

Is laparotomy the unavoidable step to diagnose caecal volvulus?
MedLine Citation:
PMID:  20529467     Owner:  NLM     Status:  MEDLINE    
Caecal volvulus is the axial twist of the caecum, ascending colon and terminal ileum around the mesenteric pedicle. This infrequently encountered clinical entity is responsible for 1-1.5% of all intestinal obstruction with a mortality of 10-40% depending on the presence of colon viability or intestinal gangrene. Many factors have been referred as correlated to caecal volvulus development, mainly anatomical predisposition and previous abdominal operations. Pre-operative diagnosis plays an important role in the management of such patients. Unfortunately, clinical signs, symptoms and laboratory tests are never specific enough to lead to a prompt diagnosis. Abdominal radiography and computed tomography may allow a diagnosis if typical signs are present. However, up to 30% of patients do not show these radiographic peculiarities, making the diagnosis difficult or impossible. Moreover, the low incidence of this disease is often responsible of a wrong or imprecise diagnosis, especially for radiologists who work with low volume of patients. We report a case of a patient with caecal volvulus, in which laparotomy was unavoidable to reach a diagnosis.
Elia Pulvirenti; Laura Palmieri; Adriana Toro; Isidoro Di Carlo
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-06-07
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  92     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-14     Completed Date:  2010-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  W27-9     Citation Subset:  IM    
Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Catania, Italy.
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MeSH Terms
Cecal Diseases / diagnosis*,  radiography,  surgery
Intestinal Volvulus / diagnosis*,  radiography,  surgery
Tomography, X-Ray Computed

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