Caecal bascule: a case series and literature review

Park, Jin‐Soo; Ng, Kheng‐Seong; Young, Christopher J.

doi:10.1111/ans.13898

Cited by 8 publications

(9 citation statements)

References 13 publications

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“…Also involved in this process are the ascending colon and terminal ileum. This should be differentiated from caecal bascule in which the caecum folds anteriorly along a horizontal plane [7,18,19]. See Many scholars report three types of caecal volvulus [20][21][22]:…”

Section: Pathophysiologymentioning

confidence: 99%

Caecal Volvulus

Okeny¹

2020

Intestinal Obstructions

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Colonic volvulus is the third leading cause of large bowel obstruction. About 35% of these are located in the caecum. Though, relatively, a rare cause of obstruction, the incidence of caecal volvulus is steadily increasing at a rate of about 5% per year. Mortality due to caecal volvulus may be as high as 40% especially in the presence of gangrene and sepsis. Clinical presentation may be acute and fulminant or as a mobile caecum syndrome with intermittent abdominal pain. "Whirl," "Coffee bean," and "bird beak" signs seen on computed tomography are pathognomonic. Colectomy is the preferred treatment as it obviates any chance of recurrence. A conservative approach to colectomy such as limited ileocaecal resection and ileostomy formation in critically ill patients or in those with poor physiological reserve may be associated with better postoperative outcomes.

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Section: Pathophysiologymentioning

confidence: 99%

Caecal Volvulus

Okeny¹

2020

Intestinal Obstructions

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“…Other risk factors include recent surgery, previous abdominal surgery, ileus, chronic constipation, and distal colonic obstruction [4] , [6] . An association has also been shown with pregnancy or the postpartum abdomen and is hypothesized to be due to mass effect [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Cecal bascule is a rare form of a cecal volvulus characterized by an anterior and superiorly displaced cecum in turn causing compression of the ascending colon that can result in a large bowel obstruction [1] , [2] . Bascule derives from French, meaning ‘seesaw’, or counterbalanced bridge [3] .…”

Section: Introductionmentioning

confidence: 99%

Cecal bascule – A rare cause of cecal volvulus after cesarean section

Bakshi

Pereira

Massad

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Cecal bascule is a rare form of a cecal volvulus characterized by an anterior and superiorly displaced cecum in turn causing compression of the ascending colon that can result in a large bowel obstruction. We report a case of cecal bascule in a newly postpartum patient, with emphasis on clinical presentation, radiologic findings and treatment. Case presentation A 37-year-old female who underwent an uncomplicated c-section and bilateral salpingectomy developed severe abdominal pain, vomiting, and peritonitis 12 h after surgery. A computerized tomography of the abdomen and pelvis revealed a dilated and superiorly displaced cecum. The diagnosis of cecal bascule was confirmed intraoperatively and a right hemicolectomy was performed. The patient recovered appropriately and was discharged on postoperative day six. Discussion Cecal bascule is the rarest form of cecal volvulus. In the context of obstetrics and gynecology, it has mostly been mentioned perioperatively after cesarean, but was also reported in an antepartum patient. It usually occurs in patients with redundant or mobile cecum, which is a result of incomplete fixation of the cecum to the retroperitoneum during embryogenesis. Other risk factors include recent surgery, previous abdominal surgery, ileus, chronic constipation, and distal colonic obstruction. An association has also been shown with pregnancy or the postpartum abdomen and is hypothesized to be due to mass effect. Conclusion Cecal bascule is a serious entity requiring a high index of suspicion and warranting greater awareness in the post-natal patient. Clinical diagnosis, prompt imaging, and surgery are important to avoid bowel ischemia and perforation.

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“…Common symptoms of a cecal bascule and their prevalence are distension (84%), abdominal pain (61%) and vomiting (30%) [ 3 ]. Unlike a volvulus, the symptoms of a cecal bascule may occur intermittently [ 20 ]. Prompt diagnosis requires a high index of suspicion as delay leads to gangrenous necrosis or colonic perforation which results in maternal and fetal morbidity and mortality [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Cecal bascule in pregnancy: a case report and review of the literature

Kreinces

Robbins

Kim

2023

Journal of Surgical Case Reports

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A 36-year-old female at 36 weeks’ gestation presented with right upper quadrant abdominal pain. She had no prior surgeries. Her pregnancy had been uncomplicated up until her presentation. Abdominal ultrasound was negative for cholecystitis or cholelithiasis, and the appendix was not visualized. During the second day of her hospital course, an abdominal magnetic resonance imaging (MRI) was performed revealing dilated small intestine with air-fluid levels and an inverted-appearing, prominent cecum. She was urgently taken to the operating room for cesarean section followed by abdominal exploration. After delivery of the child, a cecal bascule was found, with a severely distended cecum. To our knowledge, this is the first report of a cecal bascule diagnosed by MRI, and the first diagnosis of cecal bascule in a pregnant patient requiring surgical intervention. We discuss the pathophysiology, diagnosis and treatment of cecal bascule and review the current literature of reported cases.

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Caecal bascule: a case series and literature review

Abstract: Correct diagnosis of caecal bascule requires a high index of suspicion and avoids delay of appropriate management. Recent operation, particularly laparoscopic cholecystectomy, may be contributing factors. Resection is recommended, a sentiment echoed by reported cases in the literature.

Cited by 8 publications

References 13 publications

Caecal Volvulus

Caecal Volvulus

Cecal bascule – A rare cause of cecal volvulus after cesarean section

Cecal bascule in pregnancy: a case report and review of the literature

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