Ileo-colic volvulus

ABSTRACT

Three cases of volvulus of the right colon are presented, and the current literature is reviewed. Prompt diagnosis based on clinical suspicion and plain abdominal radiographs can be made. Urgent operative treatment is mandatory. If gangrene has already occurred or if the volvulus cannot be untwisted, primary resection or a Mikulicz procedure should be performed depending on the patient's condition after applying soft clamps to the bowel proximally and distally. In non-gangrene cases, simple detortion is inadequate. Right hemicolectomy may be performed in the fitter patients but caecopexy of the peritoneal flap type has been shown to be promising, and appears to be as effective and perhaps safer in less experienced hands. (AU)