Caecal volvulus with intestinal malrotation: need for caecopexy?

Description

Caecal volvulus accounts for 30% of all colonic volvulus.1 It occurs due to torsion or hyperflexion of an enlarged, poorly fixed hypermobile caecum. It manifests in two forms: axial rotation of the caecum and the ileum around the mesentery and the less common caecal bascule, where the bowel folds up on itself.2 Intestinal malrotation occurs due to incomplete or faulty rotation and fixation of the gut during the 5th to 11th week of fetal life. A combination of both is rare.

A 10-year-old boy presented with the complaints of right lower quadrant pain, bilious vomiting and non-passage of stools since 2 days. On examination, the child was dehydrated, had tachycardia, had low-volume pulse, had blood pressure of 86/60 mm Hg and had a grossly distended abdomen with no well-defined lump or signs of peritonism. His per rectal examination revealed an empty collapsed rectum. X-ray abdomen was...

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