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June 19, 1981

Volvulus of the Cecum and Right Colon

Author Affiliations

From the Department of Diagnostic Radiology, Hahnemann Medical College and Hospital, Philadelphia.

JAMA. 1981;245(23):2433-2435. doi:10.1001/jama.1981.03310480049032

VOLVULUS of the cecum and right side of the colon causes up to 10% of all cases of intestinal obstruction in adults. As reported in recent series, it is only slightly less common than sigmoid volvulus.2,3 It is more prevalent after age 50 years, although it can occur at any age. No clear-cut gender predisposition exists.4 Gangrenous change in the bowel wall occurs in two thirds of late-diagnosed cases, with an associated mortality of more than 40%.1,5

Pathophysiology  Volvulus of the cecum and right colon occurs when a segment of bowel and mesentery twists on itself, causing obstruction of the bowel lumen and, at times, occlusion of the mesenteric vessels. The term "cecal volvulus" to describe this condition is a misnomer, since the volvulus will usually involve also the right colon as well as the cecum.5 Two conditions must be met for this entity to occur: