Abstract
A 30-year old man with cerebral palsy visited a local clinic complaining of abdominal distention, and was medicated. However, his abdominal symptoms did not improve, and he visited our hospital. Physical examination showed obvious abdominal distention with peritoneal signs in the lower abdomen. Abdominal computed tomography (CT) revealed the whirl sign like appearance of the intestinal mesentery, ascites in the Douglas pouch, and the distended small bowel in the pelvic space.
He was thus diagnosed as torsion of the bowel with strangulation, and underwent emergency laparotomy. Intraoperatively, ileocecal portion was rotated counterclockwise by 360 degree. The rotated bowel was strangulated with extensive ischemic changes. Therefore, the discolored bowel was resected and was anastomosed. His postoperative course was uneventful and oral intake was started on postoperative day 3. He was discharged 20 days after surgery and remains well.
The cecal volvulus often occurs in patients with cerebral palsy and senior persons, and their physical examination may not be pathognomonic, for which early establishment of definite diagnosis and urgent operation are important.
