DOI: https://doi.org/10.36347/sjmcr.2026.v14i07.022

Pages: 1703-1707

Cecal volvulus is a rare cause of intestinal obstruction that results from an abnormally mobile cecum twisting around its mesenteric axis. Its non-specific clinical presentation and the relative unfamiliarity of clinicians with the condition frequently delay diagnosis and treatment, exposing the patient to bowel ischaemia, necrosis and perforation. Contrast-enhanced abdominal computed tomography (CT) is currently the most effective imaging modality for confirming the diagnosis and detecting complications. We report the case of a 20-year-old woman admitted for acute intestinal obstruction with abdominal pain, obstipation and bilious vomiting, without fever or haemodynamic instability. Abdominal CT showed marked cecal distension, dilatation of the small bowel and an absence of gas in the distal colon, together with the characteristic whirl sign, indicating an axial cecal volvulus without radiological signs of ischaemia or perforation. An emergency laparotomy confirmed an axial torsion of the cecum involving the terminal ileum, with marked distension and preperforative serosal tears; a right hemicolectomy with primary side-to-side ileo-transverse anastomosis was performed. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day, remaining asymptomatic at one month. This observation is noteworthy because of the young age of the patient, the absence of recognised predisposing factors, and successful management before the development of ischaemia or perforation. It illustrates the value of early CT in young patients presenting with acute intestinal obstruction, since prompt recognition of the whirl sign allows timely surgery. Right hemicolectomy with primary anastomosis remains the treatment of choice, as it definitively eliminates the risk of recurrence while providing excellent long-term outcomes, whereas conservative fixation procedures are now reserved for exceptional circumstances. Early diagnosis and prompt surgical inte