Cecal Bascule

History: 40 year old male with abdominal pain.

Cecal Bascule: Coronal CT of the abdomen and pelvis with oral and IV contrast reveals a dilated stool filled cecum on the left side of the abdomen. The right lower quadrant of the abdomen is filled with small bowel loops.

The differential diagnosis in this case includes both cecal bascule and cecal volvulus. A volvulus is a rotational twist of the colon or small bowel on its own axis, which eventually will lead to ischemia and necrosis of the bowel by impairing arterial inflow and venous outflow. A cecal bascule is when the cecum folds superiorly onto the ascending colon. The treatment for the two entities is identical and includes laparatomy and decompression of the obstruction with possible bowel resection in the event of bowel necrosis.

This  patient went on to laparotomy and the cecum was discovered to have returned to its normal position with resolution of colonic obstruction. This was a cecal bascule.