Laparoscopic surgery for repeated cecal volvulus with intestinal malrotation: A case report

• Published in: Asian journal of endoscopic surgery Vol. 13; no. 3; pp. 419 - 422
• Main Authors: Abe, Shinya, Tamura, Noriyasu, Hamasaki, Shunsuke, Umetani, Naoyuki
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-07-2020; Wiley Subscription Services, Inc
• Subjects: Case reports; cecal volvulus; Gastrointestinal surgery; intestinal malrotation; laparoscopic surgery; Laparoscopy; Surgeons; cecal volvulus; laparoscopic surgery; intestinal malrotation
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.12764

This is the first report of laparoscopic surgery for an advanced‐age patient with cecal volvulus accompanied by intestinal malrotation. A 96‐year‐old woman who had previously undergone laparotomy for cecal volvulus underwent emergency laparoscopic surgery for recurrent volvulus. Because the cecum was about to rupture but not ischemic, we untwist the intestinal volvulus and fixed the cecum to the abdominal wall with a single suture. Five days after the surgery, the volvulus between the suture and the hepatic flexure of the colon recurred. We performed a second laparoscopic surgery in which we fixed the right side of the colon to the abdominal wall after diagnosing intestinal malrotation. Given its positioning, the sign of malrotation would not have been visible on preoperative CT images. As shown by this case, intestinal malrotation might lie behind the repeated cecal volvulus, and laparoscopic surgery may be a good option for volvulus with intestinal malrotation, even in cases with obstruction.