Twist of fate: Resolving cecal volvulus with timely surgical intervention in a middle-aged female

Introduction and importance: Cecal volvulus is an uncommon cause of large bowel obstruction that typically presents in older adults with a history of chronic constipation or prior abdominal surgery. However, this report documents a rare and atypical case of cecal volvulus presenting in a middle-aged female with no significant past medical or surgical history. This case also highlights the benefits of adopting a synergistic approach between a physician's clinical judgment and the patient's presentation when making a diagnosis to ensure timely interventions and prevent life-threatening complications.

Case presentation: A 40-year-old female with no significant medical or surgical history presented to the emergency department with acute onset of severe abdominal pain radiating to the lower back, associated with nausea, vomiting, and constipation. CT imaging revealed a markedly distended cecum with evidence of volvulus. Despite the absence of common predisposing factors of cecal volvulus, the patient was correctly diagnosed. She underwent an urgent right hemicolectomy with primary anastomosis, which was uneventful. The patient had a complete recovery and was discharged home on postoperative day 5.

Clinical discussion: This case is particularly noteworthy due to the patient's atypical demographic profile and the absence of common risk factors associated with cecal volvulus. The timely recognition and surgical intervention were critical in preventing severe complications such as bowel ischemia or perforation. Furthermore, this case underscores the importance of considering cecal volvulus in the differential diagnosis of acute abdominal pain, even in patients who do not exhibit conventional risk factors.

Conclusion: This case report highlights a rare presentation of cecal volvulus in a previously healthy middle-aged woman, emphasizing the importance of prompt diagnosis and intervention. The favorable outcome in this patient demonstrates the critical role of timely surgical management in such high risk cases.