Treatment of Cecal Volvulus with Viable Bowel When the Patient Is Considered Unfit for Resection
Clinical Scenario
This protocol addresses cecal volvulus where the bowel remains viable but the patient's overall condition makes resection unsuitable. In this population, operative planning must be adapted to what the patient can tolerate — the standard resectional approach is excluded, and a different operative strategy applies.
When This Protocol Applies
The non-resectional operative pathway is specifically reserved for patients who are considered unfit for resection of the volvulized segment. Its use outside this defined circumstance is not supported. The full protocol specifies which clinical criteria establish this designation and how operative decision-making proceeds from there.
Operative Approach — Partial Overview
Management centres on a non-resectional operative procedure. The complete protocol details the specific technique options within this approach and the considerations that guide selection between them in this clinical setting.
References
DOI: 10.1097/DCR.0000000000002159
- In patients with cecal volvulus with viable bowel, alternatives to resection include manual detorsion alone or detorsion with fixation to the abdominal wall either by suture (cecopexy) or cecostomy.
- For cecal volvulus with viable bowel, the use of non-resectional operative procedures should be limited to patients who are considered unfit for resection.
- In general, the use of a nonresection approach should be limited to clinical circumstances where a patient is unfit for a resection of the volvulized segment.
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