Colonic volvulus is the third leading cause of large bowel obstruction. About 35% of these are located in the caecum. Though, relatively, a rare cause of obstruction, the incidence of caecal volvulus is steadily increasing at a rate of about 5% per year. Mortality due to caecal volvulus may be as high as 40% especially in the presence of gangrene and sepsis. Clinical presentation may be acute and fulminant or as a mobile caecum syndrome with intermittent abdominal pain. “Whirl,” “Coffee bean,” and “bird beak” signs seen on computed tomography are pathognomonic. Colectomy is the preferred treatment as it obviates any chance of recurrence. A conservative approach to colectomy such as limited ileocaecal resection and ileostomy formation in critically ill patients or in those with poor physiological reserve may be associated with better postoperative outcomes.
Part of the book: Intestinal Obstructions