2023 Volume 43 Issue 6 Pages 989-992
A 53-year-old female patient presented to our emergency department with a 1-day history of acute persistent abdominal pain. The abdomen was distended, with marked tenderness in the region of the umbilicus. The blood test findings were normal. Abdominal plain CT showed dilatation of the colon with a positive whirl sign and dirty fat sign. Based on the symptoms and CT findings, we suspected strangulated ileus. As no additional examinations could be performed in the patient due to the severe abdominal pain, we performed an emergency exploratory laparotomy. The ileocecum was rotated clockwise by 360 degrees around the ileocolic vessels and turned to the left. No obvious intestinal necrosis was observed, but we found serosal damage. We performed ileocecal resection taking into consideration the possibility of recurrence. The patient was discharged on the 14th hospital day. We reviewed the reconstructed plain CT images after the surgery, and found that preoperative diagnosis could have been made in this case. Reconstruction of plain CT images should be considered for preoperative diagnosis in a case of suspected cecal volvulus.
