{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:45:33Z","timestamp":1783655133092,"version":"3.55.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T00:00:00Z","timestamp":1639872000000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Cecal volvulus, which is a torsion involving the cecum, terminal ileum, and ascending colon around its own mesentery, results in a closed-loop obstruction. It is a rare reported cause of adult intestinal obstruction. This study aimed to review the clinical presentation, management, and outcomes at a rural, resource-limited referral center.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We performed a retrospective review of all patients with a diagnosis of cecal volvulus between January 1st, 2009 and December 31st, 2019 at Tenwek Hospital in Bomet, Kenya. The outcome of survival was compared by the time to presentation. Mortality was also compared with prior reports of intestinal obstruction at our institution.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Thirteen patients were identified with a mean age of 52\u2009years and a mean symptom duration of 5\u2009days. All patients presented with abdominal pain and distension. Seven patients (54%) presented with perforation, gangrene, or gross peritoneal contamination. Identified risk factors were Ladds bands with malrotation, adhesions, and a sigmoid tumor. Procedures included primary resection and anastomosis (7), damage control (3) with anastomosis on second-look in 2 of these, simple surgical detorsion (1), and surgical detorsion and cecopexy (2). There were four mortalities (31%), of which all had delayed presentation with perforation and fecal contamination. Delays to presentation were associated with mortality (p\u2009=\u20090.03). Cecal volvulus resulted in increased perioperative mortality compared to all intestinal obstructions presenting to the institution (p\u2009&lt;\u20090.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Cecal volvulus carries a high risk of mortality. A high index of suspicion and early consideration in the differential diagnosis of intestinal obstruction should be considered to reduce the mortality associated with the delay in preoperative diagnosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12893-021-01416-8","type":"journal-article","created":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T12:02:14Z","timestamp":1639915334000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cecal volvulus in rural Kenya: delayed presentation contributes to high mortality"],"prefix":"10.1186","volume":"21","author":[{"given":"Kimutai R.","family":"Sylvester","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip B.","family":"Ooko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Mwachiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert K.","family":"Parker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,19]]},"reference":[{"issue":"962","key":"1416_CR1","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1136\/pgmj.2005.035311","volume":"81","author":"E Consorti","year":"2005","unstructured":"Consorti E, Liu T. Diagnosis and treatment of caecal volvulus. Postgrad Med J. 2005;81(962):772\u20136.","journal-title":"Postgrad Med J"},{"key":"1416_CR2","first-page":"92","volume":"17","author":"C Mwita","year":"2014","unstructured":"Mwita C, Muthoka J, Kanina P, Mulingwa P. Caecal volvulus in an adolescent African male: a case report and brief review of the literature. Pan Afr Med J. 2014;17:92.","journal-title":"Pan Afr Med J"},{"key":"1416_CR3","doi-asserted-by":"publisher","first-page":"162","DOI":"10.11604\/pamj.2017.28.162.12237","volume":"28","author":"K Mazine","year":"2017","unstructured":"Mazine K, Elbouhaddouti H, Toughrai I, Mouaqit O, Benjelloun E, Ousadden A, Taleb KA. Volvulus of the cecum: a rare cause of intestinal occlusion: about two cases. Pan Afr Med J. 2017;28:162\u2013162.","journal-title":"Pan Afr Med J"},{"issue":"1","key":"1416_CR4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13017-015-0001-1","volume":"10","author":"PL Chalya","year":"2015","unstructured":"Chalya PL, Mabula JB. Sigmoid volvulus and ileo-sigmoid knotting: a five-year experience at a tertiary care hospital in Tanzania. World Journal of Emergency Surgery. 2015;10(1):10.","journal-title":"World Journal of Emergency Surgery"},{"issue":"1","key":"1416_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12893-019-0561-1","volume":"19","author":"GA Mulugeta","year":"2019","unstructured":"Mulugeta GA, Awlachew S. Retrospective study on pattern and outcome of management of sigmoid volvulus at district hospital in Ethiopia. BMC Surg. 2019;19(1):1\u20135.","journal-title":"BMC Surg"},{"key":"1416_CR6","first-page":"1","volume":"1","author":"LN Purcell","year":"2020","unstructured":"Purcell LN, Reiss R, Mabedi C, Gallaher J, Maine R, Charles A. Characteristics of intestinal volvulus and risk of mortality in Malawi. World J Surg. 2020;1:1\u20137.","journal-title":"World J Surg"},{"key":"1416_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11604\/pamj.2015.20.31.5830","volume":"20","author":"PB Ooko","year":"2015","unstructured":"Ooko PB, Sirera B, Saruni S, Topazian HM, White R. Pattern of adult intestinal obstruction at Tenwek hospital, in south-western Kenya. Pan Afr Med J. 2015;20:1.","journal-title":"Pan Afr Med J"},{"key":"1416_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11604\/pamj.2016.23.198.6255","volume":"23","author":"PB Ooko","year":"2016","unstructured":"Ooko PB, Saruni S, Oloo M, Topazian HM, White R. Ileo-sigmoid knotting: a review of 61 cases in Kenya. Pan Afr Med J. 2016;23:1.","journal-title":"Pan Afr Med J."},{"issue":"6","key":"1416_CR9","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1097\/00000658-197906000-00008","volume":"189","author":"CS O'Mara","year":"1979","unstructured":"O\u2019Mara CS, Wilson TH Jr, Stonesifer GL, Cameron JL. Cecal volvulus: analysis of 50 patients with long-term follow-up. Ann Surg. 1979;189(6):724.","journal-title":"Ann Surg"},{"issue":"2","key":"1416_CR10","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1007\/s10350-004-6158-4","volume":"45","author":"T Madiba","year":"2002","unstructured":"Madiba T, Thomson S, Church JM. The management of cecal volvulus. Dis Colon Rectum. 2002;45(2):264\u20137.","journal-title":"Dis Colon Rectum"},{"issue":"2","key":"1416_CR11","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1177\/145749691009900210","volume":"99","author":"M Martin","year":"2010","unstructured":"Martin M, Steele S. Twists and turns: a practical approach to volvulus and instussusception. Scand J Surg. 2010;99(2):93\u2013102.","journal-title":"Scand J Surg"},{"issue":"3","key":"1416_CR12","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s101510050034","volume":"3","author":"E Grossmann","year":"1999","unstructured":"Grossmann E, Johnson F, Enger K, Leake B, Virgo K, Longo W. Cecal volvulus: outcome of management by celiotomy. Tech Coloproctol. 1999;3(3):139\u201343.","journal-title":"Tech Coloproctol"},{"issue":"5","key":"1416_CR13","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1308\/147870810X12699662980231","volume":"92","author":"E Pulvirenti","year":"2010","unstructured":"Pulvirenti E, Palmieri L, Toro A, Di Carlo I. Is laparotomy the unavoidable step to diagnose caecal volvulus? Ann R Coll Surg Engl. 2010;92(5):e27\u20139.","journal-title":"Ann R Coll Surg Engl"},{"issue":"3","key":"1416_CR14","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1089\/lap.2007.0027","volume":"18","author":"L Ferguson","year":"2008","unstructured":"Ferguson L, Higgs Z, Brown S, McCarter D, McKay C. Intestinal volvulus following laparoscopic surgery: a literature review and case report. J Laparoendosc Adv Surg Tech. 2008;18(3):405\u201310.","journal-title":"J Laparoendosc Adv Surg Tech"},{"issue":"1","key":"1416_CR15","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/S1015-9584(09)60260-8","volume":"28","author":"SL Singla","year":"2005","unstructured":"Singla SL, Kadian YS, Goyal A, Sharma U, Kadian N. Caecal volvulus in pregnancy: is delay in diagnosis avoidable? Asian J Surg. 2005;28(1):52\u20134.","journal-title":"Asian J Surg"},{"issue":"04","key":"1416_CR16","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1055\/s-0032-1329535","volume":"25","author":"D Gingold","year":"2012","unstructured":"Gingold D, Murrell Z. Management of colonic volvulus. Clin Colon Rectal Surg. 2012;25(04):236\u201344.","journal-title":"Clin Colon Rectal Surg"},{"issue":"11","key":"1416_CR17","doi-asserted-by":"publisher","first-page":"E303","DOI":"10.1177\/000313481608201105","volume":"82","author":"A Kamyab","year":"2016","unstructured":"Kamyab A. Cecal herniation and volvulus through the foramen of winslow. Am Surg. 2016;82(11):E303.","journal-title":"Am Surg"},{"issue":"3","key":"1416_CR18","first-page":"S18","volume":"27","author":"S Bhatti","year":"2017","unstructured":"Bhatti S, Khan MA, Farooka W, Butt UI, Rehman UA, Malik AA. An unusual case of caecal volvulus due to appendicitis, successfully managed by caecopexy. J Coll Physicians Surg Pak. 2017;27(3):S18\u201320.","journal-title":"J Coll Physicians Surg Pak"},{"issue":"8","key":"1416_CR19","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1055\/s-0042-122421","volume":"55","author":"C Beltzer","year":"2017","unstructured":"Beltzer C, Geiger A, Schmidt R, Danz B, Maier A, Karpa R, Dikopoulos N. A rare case of coecal volvulus after colonoskopy due to a mobile coekum-diagnosis, surgical therapy and postoperative complications. Z Gastroenterol. 2017;55(8):766\u201371.","journal-title":"Z Gastroenterol"},{"key":"1416_CR20","first-page":"bcr2014208097","volume":"2014","author":"D Muller","year":"2014","unstructured":"Muller D. Caecal volvulus after cardiac surgery. Case Rep. 2014;2014:bcr2014208097.","journal-title":"Case Rep"},{"issue":"12","key":"1416_CR21","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1016\/j.ijscr.2014.11.038","volume":"5","author":"A Altaf","year":"2014","unstructured":"Altaf A, Aref H. A case report: Cecal volvulus caused by Meckel\u2019s diverticulum. Int J Surg Case Rep. 2014;5(12):1200\u20132.","journal-title":"Int J Surg Case Rep"},{"key":"1416_CR22","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.ijscr.2015.03.021","volume":"10","author":"HS de Vries","year":"2015","unstructured":"de Vries HS, Samlal RK, Maresch BJ, Hoven-Gondrie ML. Cecal volvulus caused by a large uterine leiomyoma. Int J Surg Case Rep. 2015;10:97\u20139.","journal-title":"Int J Surg Case Rep"},{"issue":"20","key":"1416_CR23","doi-asserted-by":"publisher","first-page":"2547","DOI":"10.3748\/wjg.15.2547","volume":"15","author":"T Katoh","year":"2009","unstructured":"Katoh T, Shigemori T, Fukaya R, Suzuki H. Cecal volvulus: report of a case and review of Japanese literature. World J Gastroenterol: WJG. 2009;15(20):2547.","journal-title":"World J Gastroenterol: WJG"},{"issue":"4","key":"1416_CR24","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1097\/DCR.0b013e3182404b3d","volume":"55","author":"BR Swenson","year":"2012","unstructured":"Swenson BR, Kwaan MR, Burkart NE, Wang Y, Madoff RD, Rothenberger DA, Melton GB. Colonic volvulus: presentation and management in metropolitan Minnesota, United States. Dis Colon Rectum. 2012;55(4):444\u20139.","journal-title":"Dis Colon Rectum"},{"issue":"4","key":"1416_CR25","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1024\/1023-9332.7.4.158","volume":"7","author":"U G\u00fcller","year":"2001","unstructured":"G\u00fcller U, Zuber M, Harder F. Cecum volvulus\u2013a frequently misdiagnosed disease picture. Results of a retrospective study of 26 patients and review of the literature. Swiss Surg. 2001;7(4):158\u201364.","journal-title":"Swiss Surg"},{"issue":"8","key":"1416_CR26","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1016\/j.jpedsurg.2011.10.064","volume":"47","author":"SE Folaranmi","year":"2012","unstructured":"Folaranmi SE, Cho A, Tareen F, Morabito A, Rakoczy G, Cserni T. Proximal large bowel volvulus in children: 6 new cases and review of the literature. J Pediatr Surg. 2012;47(8):1572\u20135.","journal-title":"J Pediatr Surg"},{"issue":"7","key":"1416_CR27","first-page":"380","volume":"25","author":"S Gupta","year":"1993","unstructured":"Gupta S, Gupta S. Acute caecal volvulus: report of 22 cases and review of literature. Ital J Gastroenterol. 1993;25(7):380\u20134.","journal-title":"Ital J Gastroenterol"},{"issue":"10","key":"1416_CR28","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1097\/00007611-198810000-00008","volume":"81","author":"TP Wright","year":"1988","unstructured":"Wright TP, Max M. Cecal volvulus: review of 12 cases. South Med J. 1988;81(10):1233\u20135.","journal-title":"South Med J"},{"issue":"2","key":"1416_CR29","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/S2173-5077(09)70124-3","volume":"85","author":"J Ruiz-Tovar","year":"2009","unstructured":"Ruiz-Tovar J, Garc\u00eda PC, Casti\u00f1eiras VM, Molina EM. Caecal volvulus: presentation of 18 cases and review of literature. Cirug\u00eda Espa\u00f1ola (English Edition). 2009;85(2):110\u20133.","journal-title":"Cirug\u00eda Espa\u00f1ola (English Edition)"},{"issue":"1","key":"1416_CR30","doi-asserted-by":"publisher","first-page":"95","DOI":"10.2214\/ajr.177.1.1770095","volume":"177","author":"CJ Moore","year":"2001","unstructured":"Moore CJ, Corl FM, Fishman EK. CT of cecal volvulus: unraveling the image. Am J Roentgenol. 2001;177(1):95\u20138.","journal-title":"Am J Roentgenol"},{"issue":"6","key":"1416_CR31","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/BF02552614","volume":"31","author":"G Tejler","year":"1988","unstructured":"Tejler G, Jiborn H. Volvulus of the cecum. Dis Colon Rectum. 1988;31(6):445\u20139.","journal-title":"Dis Colon Rectum"},{"key":"1416_CR32","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4293\/JSLS.2016.00076","volume":"20","author":"CA Gomes","year":"2016","unstructured":"Gomes CA, Soares C Jr, Catena F, di Saverio S, Sartelli M, Gomes CC, Gomes FC. Laparoscopic management of mobile cecum. J Soc Laparoendosc Surg. 2016;20:4.","journal-title":"J Soc Laparoendosc Surg."},{"issue":"4","key":"1416_CR33","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1111\/ases.12460","volume":"11","author":"Y Sakamoto","year":"2018","unstructured":"Sakamoto Y, Hiyoshi Y, Sakata K, Toyama E, Takata N, Yoshinaka I, Harada K, Baba H. Case of cecal volvulus successfully treated with endoscopic colopexy. Asian J Endosc Surg. 2018;11(4):402\u20134.","journal-title":"Asian J Endosc Surg"},{"key":"1416_CR34","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005215","author":"HR Many","year":"2021","unstructured":"Many HR, Otoki K, Parker AS, Parker RK. Implementation of a surgical critical care service reduces failure to rescue in emergency gastrointestinal surgery in rural Kenya. Ann Surg. 2021. https:\/\/doi.org\/10.1097\/SLA.0000000000005215.","journal-title":"Ann Surg"},{"issue":"3","key":"1416_CR35","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.ajem.2018.07.045","volume":"37","author":"BD Bauman","year":"2019","unstructured":"Bauman BD, Witt JE, Vakayil V, Anwer S, Irwin ED, Kwaan MR, Pruett TL, Harmon JV. Cecal volvulus in long-distance runners: a proposed mechanism. Am J Emerg Med. 2019;37(3):549\u201352.","journal-title":"Am J Emerg Med"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-021-01416-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-021-01416-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-021-01416-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T12:02:25Z","timestamp":1639915345000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/s12893-021-01416-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1416"],"URL":"https:\/\/doi.org\/10.1186\/s12893-021-01416-8","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"28 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Tenwek Hospital Institutional Ethics Review Committee and informed consent was waived for this retrospective review from the Tenwek Hospital Institutional Ethics Review Committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent for participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"430"}}