Cecal Volvulus: Everything You Need to Know

Medically Reviewed By Saurabh Sethi, M.D., MPH
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Cecal volvulus occurs when the cecum, a pouch at the juncture between the small and large intestines, twists around itself or its supporting structures. Depending on the type of cecal volvulus, other parts of the intestines may also twist. Cecal volvulus can result in intestinal obstruction and pain. Other symptoms may include constipation, nausea, and abdominal swelling.

According to researchers, only between 1% and 1.5% of intestinal obstructions in adults worldwide are due to cecal volvulus. However, as it can result in serious complications, it requires prompt medical treatment.

Read on to learn more about the causes, symptoms, treatment, and potential complications of cecal volvulus.

What are the types of cecal volvulus?

A person in pain lying in bed
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There are three general types of cecal volvulus.

Type Description
1This type occurs when the cecum twists in a clockwise direction.
2This type occurs when part of the cecum and part of the small intestine twist, usually in a clockwise direction.
3This type, which is also known as cecal bascule, occurs when the cecum folds upward instead of twisting.

What are the causes of cecal volvulus?

According to researchers, cecal volvulus can develop due to congenital conditions in which part of the colon does not correctly fuse to the peritoneum, which is the inner lining of the abdomen. As a result, the cecum may be more likely to detach and twist.

In addition, certain acquired factors may cause cecal volvulus:

  • prior abdominal surgery
  • pregnancy
  • chronic constipation
  • extended periods of immobility
  • high fiber consumption
  • psychotropic drugs, which can affect the intestines

What are the symptoms of cecal volvulus?

Common symptoms of cecal volvulus include:

As the twisting of the cecum can interrupt blood flow, some people may also experience a rapid heartbeat and pain that occurs when pressure on the abdomen decreases.

How do doctors diagnose cecal volvulus?

Doctors will take your symptoms and medical history into account when diagnosing cecal volvulus. They may also use certain imaging tests.

CT scans are important tools for diagnosing cecal volvulus. The condition may show characteristic signs on a CT scan, such as a “whirl” or “coffee bean” shape. Although abdominal X-rays are typically less effective than CT scans in detecting this condition, doctors may still use them to help confirm a diagnosis.

Cecal volvulus may be difficult to diagnose, as it can appear similar to other types of bowel obstructions. Prompt diagnosis and treatment are essential for cecal volvulus, and any delays can lead to severe complications.

What are the treatments for cecal volvulus?

Experts consider surgery to be the first-line treatment for cecal volvulus. The type of surgery will depend on the stability of your heartbeat and circulation, as well as the presence of any bowel damage.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, surgeons typically remove the parts of the cecum and colon that have twisted. In other cases, they may untwist the affected areas and attach the cecum to the abdominal wall to keep it in place.

What is the outlook for people with cecal volvulus?

The outlook for people with cecal volvulus is most positive among those who receive a prompt diagnosis and treatment. Researchers estimate that up to 30% of people with cecal volvulus may die without treatment.

Even with treatment, cecal volvulus can cause severe complications.

What are some potential complications of cecal volvulus?

Cecal volvulus can cause serious complications, including:

  • infections
  • abscesses
  • sepsis
  • colocutaneous fistula, which is an atypical connection between the skin and the intestinal tract or stomach
  • leakage from the reconnected intestinal sections
  • respiratory failure
  • bowel obstruction

Without treatment, cecal volvulus can also cause the cecal tissues to die. This can, in turn, lead to acute peritonitis, which is severe inflammation of the peritoneum.

Frequently asked questions

Below, we provide the answers to some common questions about cecal volvulus. Dr. Saurabh Sethi has reviewed the answers.

What is the difference between cecal volvulus and sigmoid volvulus?

Cecal volvulus and sigmoid volvulus involve different parts of the intestines. Cecal volvulus occurs when the cecum or part of the colon twists, whereas twisting of the sigmoid colon leads to sigmoid volvulus.

Is cecal volvulus an emergency?

Yes, cecal volvulus is an emergency. Researchers estimate that doctors need to treat the condition within 24–72 hours of diagnosis. Without treatment, cecal volvulus can lead to serious complications and even death.

How do you fix a cecal volvulus?

Surgery is currently the only effective treatment for cecal volvulus. Doctors may remove or untwist the affected intestinal sections. In some cases, they may securely attach the cecum to the abdominal wall.

How common is cecal volvulus?

Cecal volvulus is relatively rare, accounting for about 4% of cases of large bowel obstruction in the United States. It occurs less frequently than sigmoid volvulus.

Summary

Cecal volvulus occurs when the cecum twists around itself or its supporting structures, causing pain and intestinal obstruction. People with this condition may also experience nausea, abdominal swelling, and constipation.

Certain congenital conditions may cause cecal volvulus. People who have undergone prior abdominal surgery, are pregnant, or are taking psychotropic drugs may also have an increased risk of developing cecal volvulus.

Doctors generally diagnose cecal volvulus with a physical examination and radiological tests. Surgery is the standard treatment. Cecal volvulus can cause severe complications, so a prompt diagnosis and treatment are critical.

Contact your doctor right away if you are experiencing symptoms that indicate cecal volvulus.

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Medical Reviewer: Saurabh Sethi, M.D., MPH
Last Review Date: 2022 Aug 24
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