Pediatric Cecal Volvulus

Etiology:
Imaging AXR: Markedly dilated air-filled loop of bowel in the left upper quadrant with air-fluid level in this segment
Imaging Enema: Bird’s beak obstruction of the ascending colon which points towards a dilated cecum
DDX:
Complications:
Treatment:
Clinical:

Radiology Cases of Cecal Volvulus

Enema of cecal volvulus — AXR AP taken immediately after an enema shows multiple dilated loops of air-filled small bowel with no reflux of contrast into the terminal ileum. The ascending colon ends in a beak which points to a dilated air-filled cecum in the right lower quadrant.

Radiology Cases of Cecal Volvulus Due to Meconium-filled Cecum Resulting in Colonic Atresia

US and enema of colonic atresia due to in-utero cecal volvulus — Transverse US of the the abdomen (left) shows a large round meconium filled lesion anterior to the right kidney which is at the bottom left of the image. AP image from an enema (right) shows a microcolon with the cecum in the midline of the abdomen. The terminal ileum could not be refluxed.

Surgery Cases of Cecal Volvulus

Surgical image of cecal volvulus — Surgical image shows an extremely distended cecum twisted around the pateint’s appendicovesicostomy tract. The distal ileum was also extremely dilated.