Cecal volvulus with pneumatosis coli

Discussion:

The patient was promptly ushered to the operating room, where she underwent a right hemicolectomy.

From the surgical report: Cecal volvulus. Signs of ischemia in the terminal ileum and ascending colon.

The surgeon told the radiologist that he felt and heard crepitations when handling the cecum, thereby confirming pneumatosis coli.

Pathology report:

Colon (right colectomy): ischemic necrosis involving the entire wall thickness, with edema and congestion. Fresh hemorrhages in the submucosa and periserosal fat. Viable proximal and distal resection margins.
Appendix: no remarkable changes seen.
Lymph nodes (pericolonic): Fifteen lymph nodes, hyperplasia, congestion.
Omentum: congestion of blood vessels, fresh hemorrhages.

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