Intestinal Obstruction by Cecal Volvulus: A Diagnostic Challenge

Abstract

Cecal volvulus is a rare cause of intestinal obstruction, resulting from torsion of the cecum, terminal ileum, and, occasionally, the ascending colon. Its nonspecific clinical presentation makes early diagnosis challenging, and in the absence of timely intervention, it may progress to ischemia, necrosis, and intestinal perforation. This report aims to describe a case of type III cecal volvulus in a patient without comorbidities or relevant medical history, discussing the clinical findings, diagnostic workup, therapeutic management, and outcome in light of current literature. A 31-year-old male patient with no known comorbidities presented with progressive abdominal pain, distension, nausea, and absence of bowel movements. Abdominal computed tomography revealed dilated bowel loops without a clearly defined obstructive cause, and laboratory tests showed elevated serum creatinine levels. Due to failure of conservative management, an exploratory laparotomy was performed, which revealed a type III cecal volvulus. A right hemicolectomy with ileotransverse anastomosis was carried out. The patient had a favorable postoperative course, with recovery of renal function and complete resolution of clinical symptoms. Although rare, cecal volvulus should be considered among the differential diagnoses in cases of acute obstructive abdomen. Early recognition and appropriate surgical intervention, such as right hemicolectomy, are essential to prevent severe complications and reduce the risk of recurrence.