Post-operative Cecal Volvulus After Extensive Mobilization of the Right Colon During Laparoscopic Appendectomy

Abstract

Cecal volvulus can be a rare and challenging diagnosis. We report a 47-year-old female who presented to the hospital and was diagnosed with acute appendicitis based on workup and clinical exam. The patient underwent laparoscopic appendectomy where the appendix was localized after extensive ascending colon mobilization. The patient’s post-operative course was complicated by cecal volvulus requiring a right hemicolectomy. There have been several other reported cases of cecal volvulus following laparoscopic appendectomy, both of which also involved considerable cecal mobilization. More data are necessary to determine whether this clinical course could have been prevented with more limited mobilization or with cecopexy at initial surgery. A mobilized cecum may benefit from early surgical intervention to prevent future volvulus or a chronic mobile cecum syndrome. Cecal volvulus should be considered in the case of worsening abdominal pain or obstruction following laparoscopic appendectomy, given the consequences that can result if symptoms are overlooked.