Surgical Treatment of Cecal Volvulus

Purpose: Right sided intestinal volvulus is considerably rare and requires high clinical suspicion in diagnosis and prompt surgical intervention. Several surgical procedures have been employed for the treatment of this condition, and there is no wide agreement on the most appropriate technique. The aim of this study is describe our experience with volvulus of the cecum and the outcome of different management strategies. Methods: A cohort retrospective study was conducted, including all patients diagnosed with cecal volvulus between January 2012 and January 2016. Results: Nine patients were diagnosed and treated for cecal volvulus. 3 patients (33.3%) underwent a failed attempt for endoscopic decompression. 8 patients (88.8%) were operated urgently and one patient with spontaneous resolution at initial presentation was operated subsequently. Five patients (55.5%) underwent right colonic resection and 3 patients (33.3%) underwent cecopexy. One patient underwent a tube cecostomy. Post-operative complications occurred in 5 patients (55.5%) and 3 patients died (33.3%) in the post-operative period, all considered high risk patients prior to surgery. Conclusion: Cecal volvulus is a clinical emergency requiring immediate intervention. Endoscopic intervention in cecal volvulus should not be attempted. Selection of the surgical procedure should rely on the clinical presentation of the patient and surgical judgment.