PMC9360906_01
Abdominal X-ray showing the Significant distension of the colon reaching the epigastrium and the left hypochondrium.
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Colonic haustral pattern was absent ( Figure 1).
Major caecal distension related to a caecal volvulus responsible for parietal thinning and a fatty mesentery with low attenuation after contrast injection.
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In addition, spiralled loops of collapsed cecum (giving a whirl sign) were noted, with low-attenuating fatty mesentery from the twisted bowel ( Figure 2).
Severely distended cecum occupying the right hemi-abdomen with a vertex extending into the left hypochondrium associated with necrosis and pre-perforative signs.
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During the operation, the caecum in the left hypochondrium was hugely distended and contained signs of pre-perforation, such as bowel deperitonization lesions ( Figure 3).