False regarding cecal voluvus:
Correct Answer: Cecopexy is procedure of choice.
Description: CECAL VOLVULUS -Misnomer -Involvement of ileum, cecum, transverse colon; Not only cecum. -Correct name should have been Cecocolic volvulus. -Volvulus is Mainly clockwise. -Caecum is relatively fixed. | If free or mobile | Increased chances of torsion *Predisposing factors:- -Multipara patients (due to release of relaxin) -H/O previous surgery (ligaments are divided) -Malrotation (abnormal location of cecum which is free) -Distal obstructing lesion (proximal pa of colon distention leading to torsion) *Clinical features:- Because Twisting/ is at the level of ileum -patient will present with signs and symptoms of SBO * -Colicky pain * -Bilious vomiting * -Absolute constipation *Investigations:- -IOC - Plain x-ray * KIDNEY BEAN sign -Comma shaped cecum *Treatment:- Ileocecectomy + Ileotransverse anastomosis - Most cases require operation to correct the volvulus and prevent ischemia. - If ischemia has already occurred, immediate operation is obviously required. Right colectomy with primary anastomosis is the procedure of choice In frankly gangrenous bowel, resection of the gangrenous bowel with ileostomy is a safer approach - Recurrence rates are high with cecopexy, and right colectomy remains the procedure of choice for cecal volvulus.
Category:
Surgery
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