Twist in the cecum: A case series of mobile cecum, cecal volvulus and cecal bascule

The case series involves 4 patients aged 60-71 years with unusual cecal pathology: mobile cecum, cecal volvulus, and cecal bascule. The clinical manifestations were diverse, showing chronic and intermittent abdominal pain on 1 side, and acute intestinal obstruction on the other, indicating the diagnosis challenge of the conditions. The diagnosis in all cases relied on computed tomography, but there was 1 presentation that was first thought to be gastric distention, underlining the importance of meticulous radiologic evaluation. One patient experienced postoperative volvulus, and another incidental appendiceal neoplasm. Three patients needed surgical management which consisted of open hemicolectomy and robotic-assisted ileocolic resection whereas 1 was treated conservatively. The importance of having high index of suspicion of cecal pathology in patients who have unexplained symptoms and are either elderly or postoperative is emphasized in this series. Detection during CT early and timely management to avoid ischemia, perforation, and negative outcomes is crucial.