A Rare Case of Simultaneous Cecal and Sigmoid Volvulus in an Elderly Woman

BACKGROUND: Volvulus is an acute surgical emergency that involves the twisting of a segment of the gastrointestinal tract around the mesentery. It can lead to acute closed-loop bowel obstruction and ischemia. The sigmoid colon is the most common site of volvulus, occurring 80% of the time, followed by the cecum, occurring 15%. In the United States, large bowel obstruction due to cecal volvulus is rare. Simultaneous cecal and sigmoid volvulus is exceedingly rare.
CASE REPORT: Here, we report a case of a 70-year-old female patient who presented with abdominal pain, nausea, and vomiting. Abdominal computed tomography revealed sigmoid volvulus, and the patient underwent decompressive colonoscopy. The patient initially reported improved symptoms but developed abdominal distension the next day.
The patient was taken for an exploratory laparotomy and was found to have both cecal and sigmoid volvulus. To address the cecal volvulus, a right hemicolectomy with primary ileal-transverse colon anastomosis was performed. Next, our attention was brought to the sigmoid volvulus, in which a sigmoidectomy with primary colorectal anastomosis was performed.
CONCLUSIONS: The patient subsequently regained bowel function on postoperative day (POD) 5. She was subsequently discharged on POD 12. Colonic volvulus involving both the cecum and sigmoid colon is extremely rare. To the best of our knowledge, this is the sixth reported case to have developed both conditions simultaneously.

Keywords: Abdomen, Acute, general surgery, Intestinal Volvulus