Síndrome oclusivo por vólvulo de ciego

Abstract

The present clinical case analyzed the diagnosis, evolution and treatment of a 80-year- old man, who came to the emergency department, for abdominal pain of great intensity, in epigastrium and mesogastrium, with more than 20 occasions of moderate bilious vomit, and a history of cholelithiasis 5 years ago. After the presumptive diagnosis, the laboratory and imaging tests were carried out to ratify the diagnosis, performing emergency surgery for obstructive abdomen or occlusive syndrome with vascular disorder, performing exploratory laparatomy + right hemi colectomy + terminal ileum anastomosis; finding a cecum volvulus with rotation on its axis that had caused ischemia. The postoperative care plan was stricter, as pain control, vital signs and professional and family support emotionally and morally; following a favorable postoperative progress can ensure normal activity after full recovery. This study concluded that is possible to show that the treatment of cecum volvulus depends on its timely diagnosis, the pathological history can highlight difficulties and strategies to direct the disease towards a less invasive alternative, this clinical case was solved only with surgery due to check the state of intestinal obstruction in the histopathological study; and, although there is controversy between conventional and surgical medical treatment, the best therapeutic choice will always depend on the patient's condition, the assessment benefits of the present clinic and the risks of treatment strategies, according to the causes, clinical characteristics, age, complications and pathology.