A Case Report of Cecal Volvulus in a Young Child

Abstract

We report a case of cecal volvulus in a 9-year-old boy. The patient was referred to our hospital for abdominal pain and vomiting, and plain abdominal X-ray showed a giant colonic gas shadow with air-fluid level. The abdominal computed tomography showed the whirl sign. On diagnosis of a small intestinal volvulus, emergency laparotomy was performed. His cecum was twisted 720 degrees clockwise. Since the intestinal wall had become necrotic, an ileocecal excision was performed. We recognized that his cecum was mobile. When abdominal images were retrospectively reviewed, the plain abdominal X-ray portrayals revealed a markedly dilated loop of the large bowel located in the left half, and the small intestine located in the right. These images were typical findings of cecal volvulus. Although cecal volvulus is rare as a cause of intestinal obstruction in children, it should be considered as a differential diagnosis of the ileus.