Cecal volvulus after open right hepatectomy.

Abstract

Cecal volvulus, a rare cause of postoperative bowel obstruction, involves the twisting of the cecum and its mesentery, leading to the risk of ischemia. We present a case of cecal volvulus following open right hepatectomy in a patient in her 70s with no prior abdominal surgeries. On postoperative day six, after developing abdominal distension and pain, a CT scan revealed bowel obstruction and a cecal volvulus was suspected. Emergency laparotomy confirmed cecal volvulus with a highly mobile cecum, necessitating right hemicolectomy with end-ileostomy due to sepsis. The patient's recovery was prolonged due to complications, including postoperative paralysis and fascial dehiscence. To our knowledge, this is the first documented case of cecal volvulus following right hepatectomy, likely due to altered anatomy and postoperative paralysis. This case underscores the importance of considering cecal volvulus in postoperative obstruction cases, especially following surgeries affecting right-sided visceral structures.