Treatment of caecal volvulus

Treatment of caecal volvulus

At operation the volvulus is frequently found to be ischaemic and needs resection. If viable, the volvulus should be reduced. Sometimes, this can only be achieved after decompression of the caecum using a needle. Further management consists of either resection or fixation of the caecum to the right iliac fossa (caecopexy) and/or a caecostomy in those considered unfit for resection. Recurrence of volvulus after caecopexy has been reported in up to 40% of cases. - ). - - - -

Figure 78.19 Radiograph of a stent inserted for malignant colonic obstruction. Figure 78.20 The Paul–Mikulicz operation applied to volvulus of the pelvic colon.