Caecal volvulus following left-side laparoscopic retroperitoneal nephroureterectomy

Abstract

Caecal volvulus is an uncommon cause of intestinal obstruction, with a high associated morbidity and mortality. Caecal volvulus is a very rare complication following retroperitoneal surgery. As such, a high degree of clinical suspicion is warranted post operatively to minimise delay in definitively investigating and managing this condition. We present a case of an 80-year-old Caucasian woman who was admitted for an elective left-sided laparoscopic retroperitoneal nephroureterectomy for transitional cell carcinoma of the left upper pole renal calyx. Postoperatively, the patient developed intestinal obstruction, secondary to caecal volvulus. The patient underwent an emergency laparotomy and limited right-sided colonic resection with primary anastomosis.

‘Grumbling’ Midgut Volvulus in an Older Paediatric Patient With Congenital Solitary Kidney: A Case Report

“…However, several case studies have described patients who have undergone nephrectomies and then developed caecal volvulus above the age of one. These kidneys have been removed for a variety of reasons including Wilm’s tumour treatment [ 10 ], renal carcinoma treatment [ 9 , 18 ] and palliation [ 8 ]. In the majority of cases, the right kidney has been removed.…”

“…In the majority of cases, the right kidney has been removed. Papers have hypothesised the volvulus may be due to the retroperitoneal approach taken to remove the kidney or that volvulus is simply a potential complication after intra-abdominal surgery [ 18 ]. However, given the observations from this case study of a patient who was born without a left kidney developing volvulus later in life, we hypothesise that the lack of renal tissue in the retroperitoneum may predispose patients to a higher risk of volvulus, with lack of a right kidney predisposing to caecal volvulus and lack of a left kidney to midgut volvulus due to their anatomical proximity to surrounding organs.…”