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September 1984

Cecal Bascule

Author Affiliations

Hines, Ill

Arch Surg. 1984;119(9):1099. doi:10.1001/archsurg.1984.01390210089021

To the Editor.—Cecal bascule refers to the form of volvulus in which a markedly ballooned cecum is located in the pelvis.1 The condition is relatively uncommon and may cause mechanical intestinal obstruction. Although initially described in 1899 by Treves,2 it was Weinstein3 who detailed the roentgenographic and clinical findings in a classic report in 1938.

Report of a Case.—A 64-year-old man had nausea, vomiting, and abdominal distention. A flat plate of the abdomen showed a disproportionately dilated cecum (Fig 1), air-fluid levels in the proximal small intestine, and air in the distal colon. Barium studies demonstrated a major intestinal obstruction in the right lower quadrant of the abdomen with a flexion deformity at the ascending colon (Fig 2). There was no evidence of beaking, however, at the obstructed segment, as is usually seen in volvulus. At laparotomy, postappendectomy fibrotic adhesion had caused cecal fixation to

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