A rare case of cecal
volvulus in
cerebral palsy that was preoperatively diagnosed and surgically treated without complications is herein reported. A 45-year old man, who had been treated for
cerebral palsy as a result of a neonatal
cerebral hemorrhage, was admitted to our hospital because of
abdominal pain and
vomiting. A plain abdominal
X-ray film showed evidence of a huge quantity of gas in the left abdomen. Using a
gastrographin enema from the
colonoscope, an obstruction of the ascending colon was revealed with tapering of the lumen. A computed tomography scan showed a grossly dilated air-distended bowel in the left abdomen and soft tissue with internal architecture containing swirling strands of soft tissue and fat attenuation. An emergency
laparotomy was performed. During the
laparotomy the ileocecal region, which was unfixed at the retroperitoneum, was found to be twisted counterclockwise by 360 degrees around the mesentery with the terminal ileum, thus resulting in a diagnosis of cecal
volvulus. We therefore conducted an ileocecal resection. Cecal
volvulus is an uncommon form of
intestinal obstruction with a high mortality rate and may present considerable difficulty in diagnosis. Although cecal
volvulus is rare as a cause of
intestinal obstruction, it should be included in the differential diagnosis of bowel obstruction in
cerebral palsy.