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(a) Medially placed ileocecal valve (arrow). (b) Dilated, twisted cecum with tip pointing to left upper quadrant (arrow). (c) "Whirlpool" sign: tightly twisted mesentery and bowel vessels. (d) Dilated small bowel loops with air fluid levels (thick arrow) and distended gas or fluid-filled small bowel (white arrows).
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fig1
All these findings were suggestive of cecal volvulus (Figure 1).
PMC5822757_02
Elongation of the ileocolic pedicle without lateral peritoneal attachments and with hypermobile cecal apex, which could be directed toward the upper quadrant. A retrocecal, ascending appendix can also be noticed.
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fig2
The cecum had an elongation of the ileocolic pedicle without lateral peritoneal attachments and it was situated in the upper left abdominal quadrant (Figure 2).
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(a) Virtual colonoscopy. Three-dimensional volume-rendered CT colonography (anteroposterior view) showed an elongated right colon with the cecum dislocated in the upper left quadrant. (b) Virtual colonoscopy one year after surgery. Three-dimensional volume-rendered CT colonography (anteroposterior view) demonstrated the cecum and the ascending colon in the physiological position.
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fig3
After one month, a virtual colonoscopy was performed and demonstrated a large right colon in the left abdominal quadrant (Figure 3(a)), so a mobile cecum syndrome was diagnosed. She has not had pain for one year and another virtual colonoscopy demonstrated the physiological position of the cecum (Figure 3(b)).
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