Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy Complicated by Postoperative Cecal Volvulus

Background: Cecal volvulus is a rare condition in which the bowel twists around its mesenteric axis and can lead to gangrene of the bowel. Whereas it may be clinically indistinguishable from bowel obstruction, its treatment is different, and therefore, warrants accurate, early diagnosis. Case: A 48-year-old woman with symptomatic leiomyomata and adenomyosis underwent a total abdominal hysterectomy and right salpingo-oophorectomy. She was diagnosed with a cecal volvulus on postoperative day 3. Colonoscopic decompression was attempted unsuccessfully, and the patient underwent a right hemicolectomy. Conclusions: Increased awareness and a high clinical index of suspicion are necessary for the diagnosis of cecal volvulus, particularly in the postoperative period, as it clinically resembles bowel obstruction. Early diagnosis is imperative because of the risk of gangrene.