Caecum Volvulus: A Short Case Series

Caecal volvulus is an infrequently encountered clinical condition and an uncommon cause of intestinal obstruction. Patients with this condition may present with highly variable clinical presentations ranging from intermittent, self limiting abdominal pain to acute abdominal pain associated with intestinal strangulation and sepsis. Lack of familiarity with this condition is a factor contributing to diagnostic and treatment delays. Sigmoid volvulus is one of the most common presentation in Zambia and yet those of Caecum volvulus are a rare condition, but they do occur some times. In the study of the Caecum Volvulus cases over the 15 years we saw a total of 16 patients who needed surgery. There were 10 females and 6 males who presented to us needing Caecal surgery. The youngest was 17 years old and the oldest was 84 years old (the mean age being 42 year age). The most common abdominal problem was abdominal distension and abdominal pain. In our study we had more females than males and nearly all the patients had a large floating redundant Caecum. Excision of the Caecum and Ileo-colic anastomosis was done on the patients. The outcome in all the patients was good. We hypothesize that despite a possible anatomic predisposition of Caecal Volvulus in certain Zambian individuals, the exact etiology is most likely multi-factorial. Cadaveric studies of the long Caecum in Zambians need to be carried out to prove or disapprove this hypothesis.