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[Intestinal occlusion due to cecal volvulus].

Cecal volvulus is uncommon in the West and represents only 1% of cases of intestinal occlusion in adults. We describe three cases of intestinal occlusion due to cecal volvulus in two women aged 74 and 61 years old and a man aged 81 years old with multiple pathological antecedents. The patients had pain, abdominal distension and absent feces. They were treated surgically with right hemicolectomy and mechanical ileocolonic anastomosis. The postoperative course was favorable in the two women but the man died. The two female patients are currently able to perform appropriate social and occupational activities for their age and underlying diseases.

Aged↗

Midgut volvulus as a complication of intestinal malrotation in adults.

Seven adults with midgut volvulus as a complication of malrotation are presented. All patients were men with an average age of 33 years. Four presented with long histories of intermittent abdominal pain. In three patients, the twisted, corkscrew appearance of the barium column in the duodenum and proximal jejunum in an upper gastrointestinal series made the diagnosis. In the remaining patient, small-bowel follow-through performed three years before surgery showed intestinal malrotation. Three patients presented with the acute onset of severe abdominal pain. Plain films showed small-bowel obstruction and pneumatosis intestinalis in two patients and only nearly complete small-bowel obstruction in the third. Barium studies were not done in this group because of the need to proceed to exploratory laparotomy and the risk of perforation. In one patient, abdominal angiography suggested the diagnosis by showing abnormal courses of the mesenteric vessels to the volvulized segment of small bowel. All three of these patients showed ischemic segments of bowel at laparotomy.

Abdomen, Acute↗

Sigmoid volvulus.

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Colon, Sigmoid↗