Explorative laparotomy of cecal volvulus in a pediatric patient. A case report and review of literature.

ABSTRACT

INTRODUCTION AND IMPORTANCE Cecal volvulus is a rare intestinal pathology that occurs due to abnormal cecum mobility associated with spectrum of complications. It is usually manifested in adults. However, on extremely rare occasions, it occurs in pediatrics. We presented a case of cecal volvulus demonstrating the significance of early diagnosis and treatment to reach successful outcomes. CASE PRESENTATION A 12 year old boy who presented to the emergency department for clinical evaluation for acute abdomen. History and clinical examination was suggestive of acute bowel obstruction. Abdominal x-ray showed a large, distended gas filled viscus with base pointed towards the right lower quadrant. On the bases of radiological investigations, diagnosis of cecal volvolus made. Accordingly, the patient underwent emergency exploratory laparotomy. The post operative course was uneventful and was discharged in stable condition. CLINICAL DISCUSSION: Cecal volvulus is an extremely rare manifestation of intestinal obstruction and malrotation. The clinical presentation of cecal volvulus depending on the duration and extent of the involvement of cecal malrotation The exact pathogenesis of cecal volvulus is unclear. However the association of the embryological development of the colon, affects the attachment to the posterior parietal peritoneum after ordinary anatomical rotation of 270°. The core-stone management of cecal volvulus is surgical approach. CONCLUSION: Cecal volvulus requires a high index of suspicion and delicate care by the pediatric surgeon as it is considered an extremely rare entity in this age group. We highlighted the significance of early diagnosis, surgical treatment and the possibility of developing postoperative complications if left untreated.