Skip to main content

Advertisement

Log in

Cecal bascule: a systematic review of the literature

  • Review
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Background

Cecal volvulus is a rare clinical entity with an average incidence of 2.8–7.1 per million people per year, accounting for 1–2% of all large bowel obstructions. Cecal bascule is the rarest type of cecal volvulus, accounting for 5–20% of all cases. Although several case reports have been published, there is no consensus regarding its diagnosis and treatment. The aim of this study was to review the literature on cecal bascule in order to summarize the etiopathogenesis, clinical features, diagnosis, and treatment options.

Methods

The PubMed, MEDLINE, and Scopus databases were systematically searched by two independent authors. Cecal bascule was defined as anterior displacement of the distended cecum on the ascending colon without any torsion. The etiopathogenesis, clinical features, diagnosis, and treatment options were analyzed.

Results

Nineteen previously published papers reporting on 26 patients were included. The mean age of patients from previously reported cases was 55.1 ± 19.2 years, and 54% of all patients were males. Presenting symptoms included abdominal pain in 16 (61%), distension in 22 (84%), and vomiting in eight patients (30%). The mean time to diagnosis was 3.6 ± 2.6 days. The extent of surgery varied from cecopexy to right colectomy. There was no postoperative mortality. Cecal bascule recurred one 1 year after index surgery in one patient.

Conclusions

Cecal bascule is a rare clinical entity, which is mostly encountered in patients with peritoneal adhesions, mobile cecum, bowel dysfunction, and cecal displacement. In patients with recurrent or persistent abdominal pain and distension, cecal bascule should be considered. The majority of these patients require surgical management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rabinovici R, Simanski DA, Kaplan O, Mavor E, Manny J (1990) Cecal volvulus. Dis Colon Rectum 33:765–769

    Article  CAS  PubMed  Google Scholar 

  2. Perrer RS, Kunberger LE (1998) Cecal volvulus. Am J Roentgenol 171:860

    Google Scholar 

  3. Delabrousse E, Sarliève P, Sailley N, Aubry S, Kastler BA (2007) Cecal volvulus: CT findings and correlation with pathophysiology. Emerg Radiol 14(6):411–415

    Article  PubMed  Google Scholar 

  4. Ballantyne GH, Brandner MD, Beart RW Jr, Ilstrup DM (1985) Volvulus of the colon. Incidence and mortality. Ann Surg 202(1):83–92

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Haskin PH, Teplick SK, Teplick JG, Haskin ME (1981) Volvulus of the cecum and right colon. J Am Med Assoc 245(23):2433–2435

    Article  CAS  Google Scholar 

  6. Rokitansky C (1837) Intestinal strangulation. Arch Gen Med 14:202–204

    Google Scholar 

  7. Treves F (1899) Intestinal obstruction. W. Wood & Company, New York, p 135

    Google Scholar 

  8. Weinstein M (1938) Volvulus of the cecum and ascending colon. Ann Surg 107:248–259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Brandt LJ (1986) Gastrointestinal disorders of the elderly. Mod Concepts Gastroenterol 1:280

    Google Scholar 

  10. Bobroff LM, Messinger NH, Subbarao K, Beneventano TC (1972) The cecal bascule. Am J Roentgenol Radium Ther Nucl Med 115(2):249–252

    Article  CAS  PubMed  Google Scholar 

  11. Ruiz de la Hermosa A, Ortega-Domene P, Fuenmayor-Valera ML, Pérez-Morera A, Seoane-González JB (2016) Caecal bascule, an unusual cause of intestinal obstruction. Cir Cir 84(6):513–517

    Article  PubMed  Google Scholar 

  12. Chinoy M, Reyes CV (1984) Cecal bascule. Arch Surg 119(9):1099

    Article  CAS  PubMed  Google Scholar 

  13. Ferguson L, Higgs Z, Brown S, McCarter D, McKay C (2008) Intestinal volvulus following laparoscopic surgery: a literature review and case report. J Laparoendosc Adv Surg Tech A 18(3):405–410

    Article  PubMed  Google Scholar 

  14. Kim J, Nguyen S, Leung P, Divino C (2013) Cecal bascule after laparoscopic ventral hernia repair. JSLS 17(3):484–486

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lazar DA, Cohen SA, Evora DK, Losasso BE, Bickler SW (2012) Cecal bascule in a child: an unusual cause of postoperative bowel obstruction. J Pediatr Surg 47(3):609–611

    Article  PubMed  Google Scholar 

  16. Reznichenko AA, Macaluso F, Zulim R (2015) Cecal volvulus in giant ventral hernia. Int J Surg Case Rep 10:25–29

    Article  PubMed  PubMed Central  Google Scholar 

  17. Veigel MC, Dhillon G, Andresen KJ (2012) Multimodality imaging of cecal bascule: report of a case following pelvic surgery. Clin J Gastroenterol 5(3):225–229

    Article  CAS  PubMed  Google Scholar 

  18. Ellis H (1997) The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg Suppl 577:5–9

    Google Scholar 

  19. Gomes CA, Soares C Jr, Catena F et al (2016) Laparoscopic management of mobile cecum. JSLS 20(4):1–6

    Article  Google Scholar 

  20. Heller MT, Bhargava P (2014) MDCT of acute cecal conditions. Emerg Radiol 21(1):75–82

    Article  PubMed  Google Scholar 

  21. Makarawo T, Macedo FI, Jacobs MJ (2014) Cecal bascule herniation into the lesser sac. World J Clin Cases 2(12):903–906

    Article  PubMed  PubMed Central  Google Scholar 

  22. Perrot L, Fohlen A, Alves A, Lubrano J (2016) Management of the colonic volvulus in 2016. J Visc Surg 153(3):183–192

    Article  CAS  PubMed  Google Scholar 

  23. Park JS, Ng KS, Young CJ (2017) Caecal bascule: a case series and literature review. ANZ J Surg. https://doi.org/10.1111/ans.13898

    Google Scholar 

  24. Thangasamy IA, Silcock R (2010) Caecal bascule: a rare complication following emergency caesarean section. J Surg Case Rep 2010(7):8

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ramsingh J, Hodnett R, Coyle T, Al-Ani A (2014) Bascule caecal volvulus: a rare cause of intestinal obstruction. J Surg Case Rep 2014(4):rju025

    Article  PubMed  PubMed Central  Google Scholar 

  26. Garude K, Rao S (2013) Mobile cecum: an incidental finding. Indian J Surg 75(4):265–267

    Article  PubMed  Google Scholar 

  27. Ishida Y, McLean SF, Tyroch AH (2016) Cecal bascule after spinal cord injury: a case series report. Int J Surg Case Rep 22:94–97

    Article  PubMed  PubMed Central  Google Scholar 

  28. Nwanguma OR, Matsushima K, Grunfeld R, Frankel HL (2011) Colonic pseudo-obstruction (Ogilvie’s syndrome) evolving into cecal bascule. J Trauma 71(4):1082–1084

    Article  PubMed  Google Scholar 

  29. Rabin MS, Richter IA (1978) Caecal bascule—a potential clinical and radiological pitfall. Case reports. S Afr Med J 54(6):242–244

    CAS  PubMed  Google Scholar 

  30. Datta J, Sakran JV (2012) Cecal bascule with a mesenteric band acting as a ‘point of basculation’. IJCRI 3:54–56

    Article  Google Scholar 

  31. Rogers RL, Harford FJ (1994) Mobile cecum syndrome. Dis Colon Rectum 27(6):399–402

    Article  Google Scholar 

  32. Tampakis A, Droeser RA, Tampaki EC, von Holzen U, Delko T (2016) A case of cecal volvulus mimicking Ogilvie syndrome in a hospitalized patient with a pelvis fracture. Ann Med Surg 7:55–57

    Article  Google Scholar 

  33. Pousada L (1992) Cecal bascule: an overlooked diagnosis in the elderly. J Am Geriatr Soc 40(1):65–67

    Article  CAS  PubMed  Google Scholar 

  34. Consorti ET, Liu TH (2005) Diagnosis and treatment of caecal volvulus. Postgrad Med J 81:772–776

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. McIntosh SA, Ravichandran D, Wilmink AB et al (2001) Cecal volvulus occurring after laparoscopic appendectomy. JSLS 5:317–318

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Ulloa SA, Ramirez LO, Ortiz VN (1997) Cecal volvulus after laparoscopic liver biopsy. Bol Asoc Med P R 89:195–196

    CAS  PubMed  Google Scholar 

  37. Rozycki GS (2001) Special feature: image of the month. Cecal bascule. Arch Surg 136(7):835–836

    Article  CAS  PubMed  Google Scholar 

  38. Chaudry TH, Jamil M, Niaz K, Basher G (2015) Acute caecal volvulus: a diagnostic paradigm. J Pak Med Assoc 65(12):1357–1359

    PubMed  Google Scholar 

  39. Bariol SV, McEwen HJ (1999) Caecal volvulus after laparoscopic cholecystectomy. Aust N Z J Surg 69:79–80

    Article  CAS  PubMed  Google Scholar 

  40. Moore CJ, Corl FM, Fishman EK (2001) CT of cecal volvulus: unraveling the image. AJR Am J Roentgenol 177(1):95–98

    Article  CAS  PubMed  Google Scholar 

  41. Rosenblat J, Rozenblit A, Wolf E, DuBrow R, Den E, Levsky J (2010) Findings of cecal volvulus at CT. Radiology 256(1):169–175

    Article  PubMed  Google Scholar 

  42. Eggleston B, Afzal R (2011) Cecal bascule with concurrent acute appendicitis. Appl Radiol 40(10):28–30

    Google Scholar 

  43. Foy S (2014) Female patient with abdominal pain. J Emerg Med 47(3):77–78

    Article  Google Scholar 

  44. Townsend CM, Beauchamp RD, Evers BM, Mattox KL (eds) (2008) Sabiston textbook of surgery, 18th edn. Saunders-Elsevier, Philadelphia, pp 1370–1371

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Denoya.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was not obtained.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lung, B.E., Yelika, S.B., Murthy, A.S. et al. Cecal bascule: a systematic review of the literature. Tech Coloproctol 22, 75–80 (2018). https://doi.org/10.1007/s10151-017-1725-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-017-1725-6

Keywords

Navigation