Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Cecal volvulus

Richard A Hodin, MD
Section Editor
Martin Weiser, MD
Deputy Editor
Wenliang Chen, MD, PhD


A cecal volvulus is the rotation or torsion of a flexible cecum and ascending colon, frequently progressing to bowel obstruction, ischemia, necrosis, and perforation [1-5]. Volvuli can occur at other sites in the alimentary tract, including the sigmoid colon, stomach, gallbladder, splenic flexure, and small bowel [6,7].


The incidence of cecal volvulus ranges from 2.8 to 7.1 per million people per year [1,3]. Cecal volvulus accounts for approximately 1 to 3 percent of all large intestinal obstructions [8-10]. Depending upon the series and age of the patients, cecal volvulus represents 10 to 52 percent of all cases [4,11-15]. For example, a retrospective review of 137 patients with a colonic volvulus identified the following segments involved [12]:

Cecum – 52 percent

Sigmoid – 43 percent

Transverse colon – 3 percent


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Jan 2016. | This topic last updated: Nov 5, 2014.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
  1. Katoh T, Shigemori T, Fukaya R, Suzuki H. Cecal volvulus: report of a case and review of Japanese literature. World J Gastroenterol 2009; 15:2547.
  2. Pousada L. Cecal bascule: an overlooked diagnosis in the elderly. J Am Geriatr Soc 1992; 40:65.
  3. Consorti ET, Liu TH. Diagnosis and treatment of caecal volvulus. Postgrad Med J 2005; 81:772.
  4. Delabrousse E, Sarliève P, Sailley N, et al. Cecal volvulus: CT findings and correlation with pathophysiology. Emerg Radiol 2007; 14:411.
  5. Perret RS, Kunberger LE. Case 4: Cecal volvulus. AJR Am J Roentgenol 1998; 171:855, 859, 860.
  6. Yee LF. Colonic volvulus. American Society of Colon & Rectal Surgeons (ASCRS). http://www.fascrs.org/physicians/education/core_subjects/2006/colonic_volvulus/ (Accessed on October 25, 2012).
  7. Peterson CM, Anderson JS, Hara AK, et al. Volvulus of the gastrointestinal tract: appearances at multimodality imaging. Radiographics 2009; 29:1281.
  8. Rakinic J. Colonic volvulus. In: The ASCRS textbook of colon and rectal surgery, 2nd, Beck DE, Roberts PL, Saclarides TJ, et al. (Eds), Springer, New York 2011. p.395.
  9. Lee SY, Bhaduri M. Cecal volvulus. CMAJ 2013; 185:684.
  10. Baldarelli M, De Sanctis A, Sarnari J, et al. Laparoscopic cecopexy for cecal volvulus after laparoscopy. Case report and a review of the literature. Minerva Chir 2007; 62:201.
  11. Abita T, Lachachi F, Durand-Fontanier S, et al. [Cecal volvulus]. J Chir (Paris) 2005; 142:220.
  12. Ballantyne GH, Brandner MD, Beart RW Jr, Ilstrup DM. Volvulus of the colon. Incidence and mortality. Ann Surg 1985; 202:83.
  13. Hiltunen KM, Syrjä H, Matikainen M. Colonic volvulus. Diagnosis and results of treatment in 82 patients. Eur J Surg 1992; 158:607.
  14. Gingold D, Murrell Z. Management of colonic volvulus. Clin Colon Rectal Surg 2012; 25:236.
  15. Halabi WJ, Jafari MD, Kang CY, et al. Colonic volvulus in the United States: trends, outcomes, and predictors of mortality. Ann Surg 2014; 259:293.
  16. Rabinovici R, Simansky DA, Kaplan O, et al. Cecal volvulus. Dis Colon Rectum 1990; 33:765.
  17. Gupta S, Gupta SK. Acute caecal volvulus: report of 22 cases and review of literature. Ital J Gastroenterol 1993; 25:380.
  18. Husain K, Fitzgerald P, Lau G. Cecal volvulus in the Cornelia de Lange syndrome. J Pediatr Surg 1994; 29:1245.
  19. DONHAUSER JL, ATWELL S. Volvulus of the cecum with a review of 100 cases in the literature and a report of six new cases. Arch Surg 1949; 58:129.
  20. John H, Gyr T, Giudici G, et al. Cecal volvulus in pregnancy. Case report and review of literature. Arch Gynecol Obstet 1996; 258:161.
  21. Radin DR, Halls JM. Cecal volvulus: a complication of colonoscopy. Gastrointest Radiol 1986; 11:110.
  22. Sarioğlu A, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Colonic volvulus: a rare presentation of Hirschsprung's disease. J Pediatr Surg 1997; 32:117.
  23. Rogers RL, Harford FJ. Mobile cecum syndrome. Dis Colon Rectum 1984; 27:399.
  24. Habre J, Sautot-Vial N, Marcotte C, Benchimol D. Caecal volvulus. Am J Surg 2008; 196:e48.
  25. Swenson BR, Kwaan MR, Burkart NE, et al. Colonic volvulus: presentation and management in metropolitan Minnesota, United States. Dis Colon Rectum 2012; 55:444.
  26. Hashimoto Y, Shigemoto S, Nakashima A, et al. Successful preoperative diagnosis of a rare bowel obstruction: cecal volvulus. J Gastrointest Surg 2008; 12:202.
  27. Anderson JR, Welch GH. Acute volvulus of the right colon: an analysis of 69 patients. World J Surg 1986; 10:336.
  28. Moore CJ, Corl FM, Fishman EK. CT of cecal volvulus: unraveling the image. AJR Am J Roentgenol 2001; 177:95.
  29. Rosenblat JM, Rozenblit AM, Wolf EL, et al. Findings of cecal volvulus at CT. Radiology 2010; 256:169.
  30. Frank AJ, Goffner LB, Fruauff AA, Losada RA. Cecal volvulus: the CT whirl sign. Abdom Imaging 1993; 18:288.
  31. Majeski J. Operative therapy for cecal volvulus combining resection with colopexy. Am J Surg 2005; 189:211.
  32. Madiba TE, Thomson SR. The management of cecal volvulus. Dis Colon Rectum 2002; 45:264.
  33. Jones RG, Wayne EJ, Kehdy FJ. Laparoscopic detorsion and cecopexy for treatment of cecal volvulus. Am Surg 2012; 78:E251.
  34. Tejler G, Jiborn H. Volvulus of the cecum. Report of 26 cases and review of the literature. Dis Colon Rectum 1988; 31:445.
  35. Glasgow SC. Colonic volvulus. American Society of Colon & Rectal Surgeons (ASCRS). www.fascrs.org/physicians/education/core_subjects/2012/colonic_volvulus/ (Accessed on October 31, 2012).
  36. Shoop SA, Sackier JM. Laparoscopic cecopexy for cecal volvulus. Case report and a review of the literature. Surg Endosc 1993; 7:450.
  37. Mellor MF, Drake DG. Colonic volvulus in children: value of barium enema for diagnosis and treatment in 14 children. AJR Am J Roentgenol 1994; 162:1157.
  38. Schwab FJ, Glick SN, Teplick SK. Reduction of cecal volvulus by multiple barium enemas. Gastrointest Radiol 1985; 10:185.