# Cecal volvulus and nonrotation: two rare pathologic entities as culprits of intestinal obstruction—a case report

## TL;DR

A rare case of cecal volvulus and intestinal nonrotation caused severe intestinal obstruction, requiring emergency surgery for recovery.

## Contribution

This case report highlights the rare association of cecal volvulus with nonrotation and emphasizes the need for prompt surgical intervention.

## Key findings

- Cecal volvulus and nonrotation can present as life-threatening intestinal obstruction in adults.
- Early surgical intervention improved outcomes in this case of severe cecal volvulus.
- Nonrotation, though usually asymptomatic, can lead to critical complications like volvulus.

## Abstract

Cecal volvulus is a rare cause of acute abdomen, accounting for 1%–3% of intestinal obstructions, and is seldom associated with intestinal nonrotation. Early diagnosis is crucial for improving outcomes, as shown in the case of a 53-year-old male with a 24-hour history of constipation, bloating, colicky pain, and bilious vomiting. He exhibited signs of severe illness, including tachycardia, fever, and abdominal distention, with blood tests showing acute inflammation. After stabilization, an emergency laparotomy revealed a necrotic, 360°-twisted cecum and abnormal intestinal positioning. The patient underwent a right colectomy with appendectomy and ileostomy, recovering uneventfully and later having the stoma reversed. Though nonrotation is usually asymptomatic in adults, it can lead to life-threatening complications like volvulus, requiring surgical intervention. This case highlights the importance of recognizing embryologic abnormalities in adults with acute abdominal symptoms to prevent severe outcomes and underscores the need for prompt surgical treatment in cecal volvulus.