Cecum Volvulus, In Misdiagnosis of Acute Appendicitis: a case report
Date Issued
2021-11-30
Author(s)
Jovanovska, Frosina
Mustafova, Alma
Dervisov, Kristijan
Limani, Nimetula
Markov, Petar
Dalipi, Berat
Abstract
Cecum Volvulus, In Misdiagnosis of Acute
Appendicitis: a case report
Şenol Tahir, Martina Ambardjieva, Frosina Jovanovska,
Alma Mustafova, Kristijan Dervisov, Nimetula Limani,
Petar Markov, Berat Dalipi
University Clinic for Surgical Diseases, General and Abdominal
Departemen – St.Naum Ohridski, Skopje, N. Macedonia
Background: As a type of intestinal malrotation, colon
volvulus is most common in the sigmoid, followed by the
caecum and then the transverse and splenic flexure. The
cause of volvulus may be due to embryologically incomplete
rotation of the intestine, Ledd’s bands, long mesocolon, or
dolichocolon.
Methods/Results: Preoperative diagnosis of cecal volvulus
is usually accidental and can be confirmed by CT of the
abdomen, and it is an incidental intraoperative finding in
most cases. We present a patient with an operative diagnosis
for acute appendicitis, with Alvarado score of 8 and positive
ultrasonographic signs for acute appendicitis. On laparoscopic
exploration for appendectomy, an enormously dilated colon
(bigger cystic formation) affects the entire pelvis. The
conversion was performed with lower median laparotomy,
cecal volvulus found with 360-degree rotation in the direction
of the clock’s hands with more significant deterioration of the
caecum. Right hemicolectomy was performed with ileum-
transverse colon double GIA stapler anastomosis. On the 6th
postoperative day, the patient was discharged home.
Conclusions: Cecal volvulus although a rare acute surgical
condition should be recognized and properly surgically treated.
Appendicitis: a case report
Şenol Tahir, Martina Ambardjieva, Frosina Jovanovska,
Alma Mustafova, Kristijan Dervisov, Nimetula Limani,
Petar Markov, Berat Dalipi
University Clinic for Surgical Diseases, General and Abdominal
Departemen – St.Naum Ohridski, Skopje, N. Macedonia
Background: As a type of intestinal malrotation, colon
volvulus is most common in the sigmoid, followed by the
caecum and then the transverse and splenic flexure. The
cause of volvulus may be due to embryologically incomplete
rotation of the intestine, Ledd’s bands, long mesocolon, or
dolichocolon.
Methods/Results: Preoperative diagnosis of cecal volvulus
is usually accidental and can be confirmed by CT of the
abdomen, and it is an incidental intraoperative finding in
most cases. We present a patient with an operative diagnosis
for acute appendicitis, with Alvarado score of 8 and positive
ultrasonographic signs for acute appendicitis. On laparoscopic
exploration for appendectomy, an enormously dilated colon
(bigger cystic formation) affects the entire pelvis. The
conversion was performed with lower median laparotomy,
cecal volvulus found with 360-degree rotation in the direction
of the clock’s hands with more significant deterioration of the
caecum. Right hemicolectomy was performed with ileum-
transverse colon double GIA stapler anastomosis. On the 6th
postoperative day, the patient was discharged home.
Conclusions: Cecal volvulus although a rare acute surgical
condition should be recognized and properly surgically treated.
Subjects
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