Case Report
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World J Gastrointest Surg. Sep 27, 2013; 5(9): 256-258
Published online Sep 27, 2013. doi: 10.4240/wjgs.v5.i9.256
Colonic tumour precipitating caecal volvulus within a diaphragmatic hernia
Ricky Harminder Bhogal, Kambiz Maleki, Rajan Patel
Ricky Harminder Bhogal, Rajan Patel, Department of Gastroenterological Surgery, Dudley Group of Hospitals, Russell’s Hall Hospital, West Midlands DY1 2HQ, United Kingdom
Kambiz Maleki, Department of Radiology, Dudley Group of Hospitals, Russell’s Hall Hospital, West Midlands DY1 2HQ, United Kingdom
Author contributions: Bhogal RH designed the report; Bhogal RH, Patel R were attending doctors for the patients; Patel R performed surgical operation; Maleki K performed image diagnosis; Bhogal RH organized the report; and Bhogal RH wrote paper.
Correspondence to: Dr. Ricky Harminder Bhogal, Department of Gastroenterological Surgery, Dudley Group of Hospitals, Russell’s Hall Hospital, Pensnett Road, Dudley, West Midlands DY1 2HQ, United Kingdom. balsin@hotmail.com
Telephone: +44-12-15443913 Fax: +44-12-15443913
Received: July 11, 2013
Revised: September 9, 2013
Accepted: September 18, 2013
Published online: September 27, 2013
Abstract

An 85-year-old woman presented with sudden onset of generalised abdominal pain and absolute constipation for 4 d. On examination she had a distended abdomen. Plain abdominal radiograph revealed a gas filled viscous within the left upper quadrant. Subsequent computed tomography suggested caecal volvulus herniated through a left diaphragmatic hernia. The patient underwent reduction of the internal hernia, right hemicolectomy and mesh repair of the diaphragmatic hernia. Postoperative recovery was uneventful. Histology revealed a Dukes’ A colonic cancer within the caecum. Herniation of caecal volvulus through a diaphragmatic hernia is a very rare condition and may have been precipitated by the colonic tumour.

Keywords: Colonic cancer, Caecal volvulus, Bowel obstruction, Diaphragmatic hernia, Bowel ischaemia

Core tip: In patients presenting with acute bowel obstruction rare causes such as caecal volvulus must be included in the differential diagnosis. Herniation of caecal volvulus through a diaphragmatic hernia is a very rare condition and may have been precipitated by the colonic tumour.