Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: Report of a case

• Published in: Surgery today (Tokyo, Japan) Japan), 2008, Vol.38 (4), p.359-362
• Main Authors: Tsushimi, Takaaki, Kurazumi, Hiroshi, Takemoto, Yoshihiro, Oka, Kazuhito, Inokuchi, Toshihiro, Seyama, Atsushi, Morita, Tomoaki
• Format: Article
• Language: English
• Subjects: Adult; Case Report; Cecal Diseases - diagnosis; Cecal Diseases - surgery; Cecum - diagnostic imaging; Cecum - surgery; Colonoscopy; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Intestinal Volvulus - diagnosis; Laparoscopy - methods; Medicine; Medicine & Public Health; Radiography, Abdominal; Surgery; Surgical Oncology; Tomography, X-Ray Computed
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-007-3620-7

A 44-year-old woman was admitted to our hospital for investigation and treatment of sudden abdominal pain and distention. Plain abdominal radiography and abdominal computed tomography (CT) findings were suggestive of sigmoid volvulus. She underwent an emergency colonoscopy, and the scope passed easily through the sigmoid colon and reached the ascending colon quickly. However, stenosis with concentricity of the fold was observed in the cecum, which was shifted upward and to the left. Based on these findings, we diagnosed cecal volvulus caused by mobile cecum syndrome. The patient’s symptoms resolved quickly after colonoscopic reduction and elective laparoscopic surgery was performed 18 days after admission. Perioperative examination revealed a mobile cecum caused by an elongated ascending colon. We sutured the cecum and ascending colon to the lateral peritoneum laparoscopically with interrupted sutures. The patient recovered well and was discharged on postoperative day 7. An unfixed intestine can be detected easily during laparoscopic surgery, which is minimally invasive and cosmetically, physically, and economically beneficial. Thus, we recommend laparoscopic cecopexy for mobile cecum syndrome.