Two cases of volvulus of the cecum in patients of great ages over ninety

Abstract

Volvulus of the cecum is a disease that we uncommonly encounter. This time we have experienced two cases of volvulus of the cecum in patients of great ages over ninety.
A 96- and a 92-year-old man presented with ileus with the chief complaints of abdominal pain and vomiting. Following abdominal CT scanning and barium enema study, an emergency operation was performed with the most likely diagnosis of volvulus of the cecum. In the both patients the fixation of the cecum to the retroperitoneum was poor and the ileocecum had been twisted to becom necrotic. Thus the intestinal resection and reconstruction were performed simultaneously. Their postoperative courses were uneventful. Both patients were aged people over ninety who had almost stayed in bed in an institution with special care units for the aged.
Although the disease is comparatively rare, it is prospected to increase with the recent arrival of aged society. Accordingly it must be kept in mind in making the diagnosis and selecting treatments for aged patients with ileus. At present when intestinal resection can be done safely even for the aged people, the resection of the twisted ileocecum should be the operative procedure of first choice, considering possible postoperative recurrence of the volvulus.