Introduction: Colonic volvulus represents 1.9% of cases of large bowel obstruction in the United States and up to 10% to 50% of cases in Africa, the Middle East, and South America. Volvulus occurs when a segment of colon undergoes torsion along its own mesentery (Mesenteroaxial) resulting in obstruction.
Case History: A 70 year old male presents to the Emergency Department with 3 days history of worsening abdominal pain, distension, nausea, vomiting and cessation of flatus and bowel movements. As soon as patient presented to our emergency department, brief history was noted and examination was done, resuscitative measures were taken and patient was planned for emergency laparotomy.
INTRA Operatively: Small bowel dilatation noted with cecal volvulus with multiple perforations over the dilated cecum along with discoloration of ascending colon.
Discussion: The management of cecal volvulus requires emergency diagnosis and emergency surgical intervention. Any delay in diagnosis may lead to intestinal necrosis or perforation and worsening the prognosis in patients who are generally elderly. Several authors reported a high mortality rate of cecal volvulus due to delay to diagnosis and surgical intervention.
Conclusion: It is rare case of intestinal obstruction needs emergency operative management. Despite advancement in radiological imaging preoperative diagnosis is challenge.