Caecal bascule – A variant of caecal volvulus: Review of diagnostic challenges and approaches

ElsevierVolume 20, Issue 5, October 2022, Pages e262-e265The SurgeonHighlights•

Caecal bascules are rare causes of intestinal obstruction.

While the exact pathogenesis is unknown, predisposing features have been recognized.

Presenting symptoms and radiological features are often non-specific, and thus a low threshold for suspicion is required.

Volvulus entrapment has been theorized as the precipitant for further decompensation.

Laparoscopic-assisted surgical approaches may reduce mortality and can be considered in the management of selected patients.

Abstract

Caecal volvulus is a rare cause of intestinal obstruction, of which the caecal bascule is the most uncommonly encountered subtype. Definitive radiological diagnosis of a caecal bascule can be challenging. Lack of familiarity with this rare condition can contribute to delayed diagnosis and treatment, which may result in unnecessary morbidity. This article highlights the case of a patient who presented with a diagnostic challenge, and also discusses the pathogenesis and diagnostic features of caecal bascules. Various options in the surgical management of caecal bascules are reviewed, including the feasibility of laparoscopic-assisted approaches in the emergency setting.

Keywords

Caecal bascule

Caecal volvulus

Volvulus

Jackson veil

Right hemicolectomy

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© 2021 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

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