A 78-year-old woman presented with fever, severe abdominal pain, and distension.She had been institutionalized for depression and senile dementia.Laboratory examinations disclosed a leucocytosis(WBC:12 500/μL) and el...A 78-year-old woman presented with fever, severe abdominal pain, and distension.She had been institutionalized for depression and senile dementia.Laboratory examinations disclosed a leucocytosis(WBC:12 500/μL) and elevated levels of serum C-reactive protein(2.8 mEq/L).Diagnosis of acute cecal volvulus was made from a"coffee bean sign"on an abdominal computed tomography and a"beak sign"on a gastrographin enema.An emergent laparotomy confirmed the diagnosis and an ileo-colectomy with primary anastomosis was carried out.The patient recovered after intensive respiratory care and fluid therapy, and then returned to her former institution.A review of Japanese literature disclosed that:(1) a marked increase of aged patients with mental disability presenting with cecal volvulus,(2) adoption of ileo-colectomy as the standard surgical procedure, and(3) improved survival of the patients, were observed in the last decade.展开更多
文摘A 78-year-old woman presented with fever, severe abdominal pain, and distension.She had been institutionalized for depression and senile dementia.Laboratory examinations disclosed a leucocytosis(WBC:12 500/μL) and elevated levels of serum C-reactive protein(2.8 mEq/L).Diagnosis of acute cecal volvulus was made from a"coffee bean sign"on an abdominal computed tomography and a"beak sign"on a gastrographin enema.An emergent laparotomy confirmed the diagnosis and an ileo-colectomy with primary anastomosis was carried out.The patient recovered after intensive respiratory care and fluid therapy, and then returned to her former institution.A review of Japanese literature disclosed that:(1) a marked increase of aged patients with mental disability presenting with cecal volvulus,(2) adoption of ileo-colectomy as the standard surgical procedure, and(3) improved survival of the patients, were observed in the last decade.
