CAECAL VOLVULUS- A CASE REPORT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 22
Abstract
CASE PRESENTATION An 18-year-old female presented to surgical emergency with complaints of progressive abdominal distension, vomiting, constipation and fever of 3 days duration. On examination, she was febrile. Abdomen was distended with hyperperistaltic bowel sound and on per rectal examination rectum was empty. Routine blood examinations showed raised total leucocyte count and increased blood urea. X-ray abdomen showed dilated small bowel with multiple fluid level (Figure 1). With the x-ray findings, we made a diagnosis of small bowel obstruction. Initially patient was stabilised, treated conservatively and observed for 12 hrs. But she was found to be deteriorating with progressive symptoms of increasing abdominal distension. Patient was planned for emergency exploratory laparotomy as no improvement was seen with a trial of conservative treatment and patient had already reported very late, i.e. after 3 days of duration. On laparotomy we found that distal ileum, caecum, appendix and ascending colon were gangrenous (Figure 2, 3, 4). Hence, we made an intra-op diagnosis of Caecal volvulus. Limited right hemicolectomy was done for gangrenous bowel and double barrel stoma was made as the general condition and nutrition of the patient was poor. Post-operative period was uneventful. Patient was started orally on 5th post-operative day and discharged on 7th post-operative day. Stoma reversal was done after 3 months.
Authors and Affiliations
Anand Kishore
Keywords
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- EP ID EP433353
- DOI 10.14260/jemds/2018/612
- Views 76
- Downloads 0
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