Caecal volvulus sign

Caecal volvulus Radiology Reference Article

  1. A specific CT sign for volvulus is the whirl sign, which has been described in volvulus of the midgut, caecum, and sigmoid colon 3. The whirl is composed of spiralled loops of collapsed caecum and sigmoid colon. Low-attenuating fatty mesentery with enhancing engorged vessels radiate from the twisted bowel
  2. Radiology Masterclass 'Caecal Embryo Sign' In caecal volvulus, the dilated caecum takes on a shape similar to a mammalian embryo. That is, the formation of a large dilated caecal pole (head), with one or two further 'segments' (body and tail). This is seen in all the images on this page
  3. al distension

Abdominal X-ray - Abnormalities - Caecal volvulu

The CT reveals, as the main finding, a caecal volvulus with the classic whirl sign and some distended, fluid filled small bowel loops with air-fluid levels, consistent with an obstructive small bowel ileus. The free abdominal air on the CT is attributable to the recent laparascopy A cecal volvulus is the rotation or torsion of a mobile cecum and ascending colon, which causes approximately 1 to 3 percent of all large bowel obstructions [ 1-3 ]. If untreated, cecal volvulus can progress to bowel ischemia, necrosis, or perforation [ 4-8 ] CT findings of a whirl, ileocecal twist, the X-marks-the-spot sign, and the split-wall sign are specific for cecal volvulus. •. The coffee bean sign and a distended cecum directed toward the left upper quadrant on CT topograms are insensitive but specific for cecal volvulus. • The most reliable sign of cecal volvulus is the whirl sign, which is composed of a spiralled loop of the collapsed cecum and engorged mesenteric vessels.3 Surgery is the treatment of choice in patients with cecal volvulus

The CT findings more common in caecal volvulus included severe caecal distension ≥10 cm, whirl sign, abnormal caecal position, central appendix - at or close to the midline, split wall, coffee bean sign and distal colonic decompression. In the study conducted by Dane et al., [ 39] the whirl sign was an independent predictor of caecal volvulus Sigmoid/Cecal volvulus Triad: Abdominal pain, distention, constipation Vomiting only occurs late as obstruction is rather distal. If so, may be feculent in nature and indicates long-standing obstruction

The results show that although caecal volvulus occurred more often in women this was not statistically significant and that both caecal and sigmoid volvulus can occur in men and women. Additionally, only one patient with documented right-sided caecal volvulus had the CT whirl sign located in the left peritoneal cavity Register Sign in. Sign in Register Caecal volvulus accounts for 30% of all cases of volvulus of the colon. Methods. We recorded clinical data and accurate images of volvulus of the cecum. Results. A detorsion with resection and primary anastomosis was performed. We reviewed the management and surgical strategies for cecal volvulus This operation is commended for caecal volvulus in cases where the intestine remains viable. Full text Get a printable copy (PDF file) of the complete article (557K), or click on a page image below to browse page by page Volvulus is a specific cause of obstruction with characteristic X-ray appearances. Twisting of the bowel - or 'volvulus' - is a specific cause of bowel obstruction which can have characteristic appearances on an abdominal X-ray. The two commonest types of bowel twisting are sigmoid volvulus and caecal volvulus Caecal volvulus. Am J Surg 2008;196(5):e48-e49. Delabrousse E, Sarliève P, Sailley N, Aubry S, Kastler BA. Cecal volvulus: CT findings and correlation with pathophysiology. Emerg Radiol 2007;14(6):411-415

Cecal Volvulus: Causes, Symptoms, and Treatmen

  1. al CT has become mandatory for pre-operative diagnosis of intestinal volvulus. The 'whirl' sign, beak sign, intestinal twisting, and the direction of the volvulus have been described in literature
  2. Sigmoid volvulus usually presents with smooth, ahaustral margins of the involved colon and the supine radiograph shows a complete loop with its margins converging towards a point in the pelvis, in contradistinction to the incomplete 'comma-shaped' loop of caecal volvulus (Young et al., 1978)
  3. Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis
  4. CT showed caecal volvulus contained within the ventral hernia confirmed intra-operatively. Patient recovered well and was discharged on Day 6 of admission. This is the second case described in literature of a caecal volvulus occurring in an incisional hernia. The altered normal anatomy may have contributed to caecal mobility

Cecal Volvulus: Symptoms, Causes, Diagnosis, and Treatmen

Radiology plays a role to diagnose caecal volvulus since there is no specific symptoms and signs of caecal volvulus except those of intestinal obstruction. There were classic plain X-ray abdomen of coffee bean sign of caecal volvulus [8-10] and CT abdominal features of caecal volvulus [12,13] in this patient Caecal volvulus portrays torsion of the caecum around its mesentery which frequently brings obstruction. If unrecognized, it can result bowel perforation and fecal peritonitis. In general, an incomplete malrotation is fundamental for cecal volvulus to happen, on the grounds that the cecum and parts of the ascending colon are included Cecal volvulus case report Introduction Caecal volvulus portrays torsion of the caecum around its mesentery which frequently brings obstruction. If unrecognized, it can result bowel perforation and fecal peritonitis. In general, an incomplete malrotation is fundamental for cecal volvulus to happen, on the grounds tha whereas a whirl sign seen in the abdomen in the middle to left side is suggestive of sigmoid colon volvulus [4]. However, in our case distal colon decompression was ascertained but the whirl sign was seen in the abdomen on the left side. We must carefully look for the whirl sign of cecal volvulus in CT images in cases with mobil Volvulus Of The Small Bowel And Colon Abstract Europe Pmc. Mycourses. Point Of The Coffee Bean Deformity In Cecal Volvulus Is Directed. Elective Laparoscopic Right Colectomy For Caecal Volvulus Case. 20 61 Year Old Woman Presenting With Diffuse Abdominal Pain. Https Pubs Rsna Org Doi Pdf 10 1148 Radiol 10092112

A caecal volvulus occurs when there is twisting of the bowel at the caecum and resultant intestinal obstruction. The classical radiological appearance of this condition is the 'comma' sign - there is a gas-filled ileum and caecum. Treatment is by decompression and resection, or fixing of the caecum to the posterior abdominal wall Cecal volvulus accounts for about 1% of intestinal obstructions and 10%-40% of cases of colonic volvulus.1, 2 The second most common type of colonic volvulus (after sigmoid volvulus), it is associated with a lack of normal retroperitoneal attachments of the right colon. Risk factors include adhesions, malrotation, colonic distension or upward displacement of the cecum.2 Presenting signs and.

Intermittent caecal volvulus: a rare cause of right iliac fossa pain in patients with previous right oophorectom Caecal Volvulus. The second most common site for a volvulus to occur is at the caecum, accounting for around 25-40% of all colonic volvulus.There is a bimodal age of onset, in the 10-29 year group and then again in the 60-79 year group. Those in the younger group may have intestinal malformation or excessive exercise as the predisposing cause, whilst in older patients it is more associated. Volvulus occurs when a loop of intestine twists around itself and the mesentery that supplies it, causing a bowel obstruction. Symptoms include abdominal distension, pain, vomiting, constipation, and bloody stools. The onset of symptoms may be insidious or sudden. The mesentery becomes so tightly twisted that blood supply is cut off, resulting in bowel ischemia

Caecal volvulus Caecal volvulus Kulkarni, D.; Magee, D.; Mccrory, D. 2009-04-01 00:00:00 Case report A 78‐year‐old female patient was admitted with a 1‐week history of abdominal pain, vomiting and constipation. The abdominal pain was colicky in nature and localised to left iliac fosse and left lumbar region. On examination she was stable, apyrexic, but dehydrated Cecal volvulus is a rare, but potentially fatal, cause of intestinal obstruction. As computed tomographic (CT) scanning is often the initial diagnostic test in patients with acute abdominal pain, we reiterate the importance of the whirl sign in diagnosing intestinal volvulus. We report the first description of the CT diagnosis of cecal volvulus

Discussion. Colonic volvulus is an uncommon cause of colonic bowel obstruction, estimated to cause 3.4% of all colonic obstructions [7], though incidence is higher in certain areas as the middle east and Africa [8].Cecal volvulus is less common than sigmoid volvulus, and is managed almost exclusively with surgery [3].Despite similarities in pathophysiological features and diagnostic methods [9. Sigmoid volvulus. coffee bean sign = distended segment of large bowel folded back on itself so that the twisted loops causes two compartments with a central double wall ending in the apex of the twist; Caecal volvulus. large bowel dilation in pelvis but not coffee bean in appearance; sigmoid and rectum normal on C Colonic volvulus is most common in adults between the ages of 50 and 80. Sigmoid volvulus is more common in men, while cecal volvulus is more common in women. 20. Sigmoid volvulus is more common in older adults who. have chronic constipation; have mental health or nervous system disorders; have chronic medical condition An axial-type volvulus of the caecum in a 56-year-old woman with who presented with signs of shock on admission. (a,b) Coronal CT slices at the fulcrum point demonstrate a tight whirl sign (anteroposterior axis). The caecum remains in the lower part of the abdomen, on the right side. The ileo-caecal region is not involved Cecal volvulus is an uncommon cause of intestinal obstruction due to an axial twist of the caecum, ascending colon and terminal ileum around the mesenteric pedicle. It is responsible for 1%-1.5 of all intestinal obstructions in adult. The clinical signs may be highly variables and can be responsible of delays in diagnostic and treatment. The delay in diagnosis leads to intestinal necrosis or.

Signs of a caecal volvulus on computed tomography include the whirl sign (produced by a twisted loop of caecum with accompanying spiralled engorged mesenteric vessels), the bird beak sign (seen on axial images; caused by the tapered afferent and efferent loops of the volvulus converging at the site of torsion), and the coffee bean. for the diagnosis of acute caecal volvulus in the emergency setting. Coffee bean, bird beak, and whirl signs are three prevalent CT signs used in making a diagnosis of acute caecal volvulus [4,5,10]. The success rate of endoscopic decompression for caecal volvulus is only 15% to 20%, and therefore emergency surgery is required.

Later on other authors have described the same sign in sigmoid volvulus (2), even caecal volvulus (3) and adhesive mid-gut volvulus (4,5).Small-bowel volvulus can be differentiated according to its etiology into two types : primary idiopathic volvulus, in which no anatomical abnormalities can be shown, and secondary volvulus, in which. In the volvulus belt of Africa and the Middle East, nearly 50% of large-bowel obstructions are a result of volvulus, almost exclusively of the sigmoid colon. Cecal volvulus is much less common than sigmoid volvulus, accounting for 10-15% of all cases of volvulus and predominately affecting women in the sixth decade of life

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Cecal volvulus is rare in children . Although it can be found in all age groups. [ Kirks, 1981] True incidence is not known. Correct diagnosis and definitive surgical intervention may be delayed due to unfamiliarity with it. [ Kirks, 1981] Cecal Volvulus is due to a mobile right colon . Retroperitoneal attachments are lacking, which actually. The control subjects had suspicious radiographs, had undergone CT within 24 hours of radiography, and had received a clinical diagnosis other than cecal volvulus. Three radiologists independently evaluated the CT topograms for cecal distention, the coffee bean sign, cecal apex location, and distal colon decompression

Can the location of the CT whirl sign assist in

6. Rosenblat J et al. Findings of cecal volvulus at CT. Radiology. 2010;256(1):169-175. 7. Macari M et al. Can the location of the CT whirl sign assist in differentiating sigmoid from caecal volvulus? Clinical Radiolo-gy. 2011;66:112-117. 8. Rokitansky C . Intestinal strangulation . Arch Gen Med. 1837;14:202-204. 9. Radin DR, Halls JM Caecal volvulus is a rare cause of intestinal obstruction occurring for approximately 1% of cases.It is a surgical emergency caused by the axial twist of the caecum, distal ileum and proximal colon in the absence of normal caecal fixation. The main differentiating factors in post cesarean large bowel distension are sigmoid volvulus and pseudo-obstruction of colon Caecal volvulus following laparoscopy-assisted sigmoid colectomy for sigmoid volvulus

LearningRadiology - Sigmoid Volvulus

The whirl sign represents swirling strands of soft-tissue attenuation, comprising the twisted loops of bowel and branching mesenteric vessels, against a background of mesenteric fat attenuation, and the whirl sign was observed on CT scans of all patients with colonic volvulus. In another study, the whirl sign was visible in all cases of axial. Sample pathology report. Cecum and ascending colon, resection: Segment of colon with patchy transmural necrosis and serosal adhesions (see comment) Necrosis extends to distal resection margin; proximal margin unremarkable. Four benign lymph nodes. Comment: The findings are consistent with the clinical impression of volvulus as reported in the. Whirlpool sign - seen when bowel rotates around its mesentery with the vessels and collapsed bowel creating the whirls. It is found in a number of settings including malrotation complicated by midgut volvulus and caecal volvulus (as above). In midgut volvulus the swirl is counter-clockwise on CT (as if viewed from below) and clockwise on US and is analogous to the corkscrew sign seen on. Sigmoid volvulus has a spectrum of imaging findings. A classic appearance is absent on approximately one half of scanograms and one fourth of CT scans. Use of new signs that model the pathophysiologic characteristics of volvulus (X-marks-the-spot sign for more complete twisting and split-wall sign for less severe twisting) may improve.

Europe PMC is an archive of life sciences journal literature. Search worldwide, life-sciences literature Searc Volvulus is more likely to occur at times of rapid change in the uterine size and can present during pregnancy or more commonly in puerperium . Two prerequisites for development of caecal volvulus are caecal hypermobility (28% of women) and a fixed point around which rotation can occur 12) Sign in which fetal appearance is observed in AXR is called: a) Double bubble sign b) Sigmoid volvulus c) Step ladder pattern d) Caecal volvulus 13) Volvulus is defined as: a) Twisting of bowel on itself b) Twisting of bowel on its ligaments c) Twisting of bowel on its folding of peritoneum d) No correct answer 14) Crescent sign on AXR. Volvulus. Volvulus is a condition where the bowel twists around itself and the mesentery that it is attached to. The mesentery is the membranous peritoneal tissue that creates a connection between the bowel and the posterior abdominal wall. The bowel gets its blood supply from the mesentery (through the mesenteric arteries) Cecal volvulus in pregnancy: report of a case and review of the safety and utility of medical diagnostic imaging in the assessment of the acute abdomen during pregnancy. Emerg Radiol. 2008 Mar. 15(2):127-131. . Torreggiani WC, Brenner C, Micallef M. Case report: Caecal volvulus in association with a mesenteric dermoid

DIAGNOSTIC CHECKLIST. (Left) Graphic shows a twist (volvulus) of the ascending colon, obstructing the lumen and blood supply. The cecum on the mesentery is dilated and displaced toward the left upper quadrant (LUQ). (Right) Supine radiograph shows a gas-distended segment of bowel (cecum) within the mid abdomen Another differentiating features with the caecal volvulus is the presence of multiple air fluid levels in sigmoid volvulus [8]. Frimann-Dahl Sign: Three dense lines representing the sigmoid walls are seen converging at the site of obstruction in sigmoid volvulus and absence of rectal gas [9] cecal volvulus: rotation and twisting of the cecum toward the left upper quadrant, with ascending colon obstruction; associated with a cecum on a long mesentery Caecal volvulus The caecum is most frequently a retroperitoneal structure, and therefore not susceptible to twisting. However, in up to 20% of individuals there is congenital incomplete peritoneal covering of the caecum with formation of a 'mobile' caecum on a mesentery, such that it no longer lies in the right iliac fossa

Caecal volvulus | Image | RadiopaediaCecal volvulus | CMAJ

Diagnosis and treatment of caecal volvulus Postgraduate

The patient is placed in a supine position, and the abdomen is prepared and draped. A low midline incision is made. The area of the volvulus and the terminal ileum are exteriorized. The volvulus. A volvulus is a twist of the intestine around the axis of its blood supply. In the case of a sigmoid volvulus, the twist occurs in the sigmoid mesentery at its base. Sigmoid volvulus is the most common type of volvulus of the colon. Less common are caecal volvulus and volvulus of the transverse colon

Colonic volvulus is an important entity to consider in any pregnant patient with abdominal pain. X-ray and colonoscopy can be useful to obtain the earliest diagnosis, leading to surgical intervention if necessary. Limited use of x-rays with shielding of the fetus is of minimal risk and useful for early diagnosis of volvulus. Colonoscopy may confirm or exclude the diagnosis of colonic volvulus. A review of 561 cases of cecal volvulus that were published between 1959 and 1989 along with 7 new cases, was performed to characterize the clinical and laboratory profile and to evaluate the various surgical options in treating this life-threatening condition. The age and sex distribution of these patients have changed over the years and shifted toward older patients (mean, 53 years) and. A definitive sign of a cecal volvulus is the upward displacement of the appendix with obstruction of the large bowel. Comparatively, a sigmoid volvulus will show findings of a bent inner tube sign with the apex of the volvulus located in the left upper quadrant

caecal volvulus. The coffee bean sign refers to the rounded focal collection of air-distended bowel with haustral creases visualised in the left upper quadrant or anywhere within the abdominal cavity. 3 12 The bird beaks are images correlating with the progressively tapering efferent and afferent bowel loops terminating a VOLVULUS of the cecum and right side of the colon causes up to 10% of all cases of intestinal obstruction in adults. As reported in recent series, it is only slightly less common than sigmoid volvulus. 2,3 It is more prevalent after age 50 years, although it can occur at any age. No clear-cut gender predisposition exists. 4 Gangrenous change in the bowel wall occurs in two thirds of late. Fig. 3: Caecal Volvulus: Video demonstrating the value of using multi-planar reconstruction and the scroll facility in recognising the whirl sign. The images are reconstructed in the sagittal plane which is perpendicular to the axis of the whirl. The whirl sign is seen anterior to the vertebral body of L5. References: - Manchester/U

Sigmoid volvulus versus cecal volvulus Radiology

Diagnosis and treatment of caecal volvulus. Postgrad Med J. 2005 Dec;81(962):772-6. MadibaTE, T SR. The management of cecal volvulus. Dis Colon Rectum. 2002 Feb;45(2):264-7. Baldarelli M, De Sanctis A, Sarnari J, Nisi M, Rimini M, Guerrieri M. Laparoscopic cecopexy for cecalvolvulus after laparoscopy. Case report and Embryo sign Caecal volvulus. Find this Pin and more on DIGESTIVE by Stelios Daskalogiannis. Saved from slideshare.net

Whirlpool sign (mesentery) Radiology Reference Article

The famous coffee bean sign is rarely seen in caecal volvulus. Also, as shown here, in caecal volvulus the distal bowel collapses, whereas it is dilated in sigmoid volvulus. Nevertheless, plain radiography alone is often not enough to make the diagnosis, and computed tomography should be performed if caecal volvulus is suspected Caecal volvulus is the axial twist of the caecum, ascending colon and terminal ileum around the mesenteric pedicle. This infrequently encountered clinical entity is responsible for 1-1.5% of all intestinal obstruction with a mortality of 10-40% depending on the presence of colon viability or intestinal gangrene. Many factors have been referred as correlated to caecal volvulus development.

Cecal volvulus - Radiology Imaging

Giant colonic diverticulum is a rare complication of diverticular disease of the colon and is thought to result, in most cases, from a ball-valve effect. The presentation and clinical course can be variable and confusing. The most common symptoms are abdominal pain and a palpable abdominal lump, w The volvulus is usually in a counterclockwise direction when viewed from the rear and the right side of the animal. The omasum is displaced medially and can be involved in the volvulus with occlusion of its blood supply (called an omasal-abomasal volvulus) and displacement of the liver and reticulum Partial volvulus of a mobile cecocolon is a definite but rarely suspected cause of intermittent pain in the right lower quadrant of the abdomen. Usually the diagnosis of this disorder is not established until an obvious attack of intestinal obstruction occurs and laparotomy demonstrates the cecal volvulus Postgraduate MedicalJournal(November 1979) 55, 824-825 Caecal andsigmoidvolvulusin the samepatient P. G. REASBECK* M.R.C.P., F.R.C.S. RoyalHampshire CountyHospital, Winchester Summary Apatient is described who developed caecal volvulus several years after sigmoid colectomy for recurrent sigmoid volvulus. The pathophysiology of colonic volvulus is briefly reviewed, and it is suggested tha Caecal volvulus. A caecal volvulus is an uncommon cause of bowel obstruction (around 1% of cases), but is important to recognize as it can progress to bowel ischaemia and death. In most people, the caecum is fixed to the retroperitoneum, however in some people it has a peritoneal mesentery which can allow it to twist;

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Cecal Volvulus: Treatment, Diet, Causes, Symptoms, Diagnosi

Cecal volvulus represents 25-40% of all colonic volvulus. Symptoms include abdominal distension, constipation, nausea and vomiting where it may be intermittent. Abdominal X-rays and computed tomography (CT) may help with diagnosis and recommended treatment is resection of mobile caecum. Although rarely identified as a source of abdominal pain. Sigmoid Volvulus. Dilated loop of sigmoid colon has a coffee-bean shape and. the wall between the two volvulated loops of sigmoid (black arrow) points towards the right upper quadrant. There is a considerable amount of stool in the colon from chronic constipation Cecal Volvulus Resolved Spontaneously Yosuke Kunishi 1, Megumi Tsukamoto , Takafumi Yanagibashi 1, Yuki Sodani , Kazuhiro Niwa1, Koichiro Yoshie2, Yoshio Kato1 and Shin Maeda3 Abstract: Cecal volvulus is an uncommon cause of colonic obstruction. First-line treatment for cecal volvulus is sur-gery, as nonoperative management is rarely achievable

Whirl Sign 19. Conclusion • Transverse colon volvulus is very rare and causes high risk of mortality and morbidity than sigmoid and caecal volvulus. • Diagnosis can be challenging and the effective management remains controversial. • Prompt recognition with emergency intervention constitutes the key to successful outcome Advertisers Access Statistics Resources. Dr Mohan Z Mani Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for. Summary A patient is described who developed caecal volvulus several years after sigmoid colectomy for recurrent sigmoid volvulus. The pathophysiology of colonic volvulus is briefly reviewed, and it is suggested that an innate tendency to poor muscular tone in the colon may predispose to volvulus, while conversely excessive tone may lead to. Colonic volvulus is a common entity encountered by colorectal surgeons, but there are few reports of national data regarding postoperative outcomes. The aim of this study was to describe the volvulus population, 30‐day outcomes following right‐ and left‐sided colectomy and risk factors for postoperative complications

Caecal volvulus in a woman with malrotation variantInternet Scientific PublicationsAbnormalities of the Cecum on Behance

DISCUSSION. Caecal volvulus is an uncommon cause of bowel obstruction, with an estimated incidence of 2.8-7.1 per million people per year, accounting for 1%-1.5% of all adult intestinal obstructions and 25%-40% of all cases of colonic volvulus.() Although the aetiology of caecal volvulus is often thought to be complex and multifactorial, excessive caecal mobility is a commonly implicated. Caecal volvulus is an uncommon cause of acute intestinal obstruction caused by axial twisting of the caecum along with the terminal ileum and ascending colon. Early diagnosis is essential in order to reduce the high mortality rate, though the condition is rarely diagnosed correctly at the time of presentation. We report a series of four cases describing their presentation, management and.. Caecal volvulus accounts for approximately 1 to 3 percent of all large intestinal obstructions with an average incidence of from 2.8 to 7.1 per million people per year. 1 Caecal volvulus is frequently encountered in young females in comparison to the sigmoid volvulus which has preponderance in older age groups. A definitive sign of a cecal volvulus is the upward displacement of the appendix with obstruction of the large bowel. Comparatively, a sigmoid volvulus will show findings of a bent inner tube sign with the apex of the volvulus located in the left upper quadrant. Less common are caecal volvulus and volvulus of the transverse colon. Sigmoid. to definitive volvulus with obstruction due to the episodic nature of the disease, but some radiographic clues may be present. Abdominal CT has become an increasingly useful tool in diagnosing intestinal volvulus and the whirl sign has been well described in radiology literature.7 The whirl sign Caecal volvulus is a rare cause of the acute abdomen and accounts for approximately 25% of cases of acute colonic volvulus [1, 2].It can occur when the ascending colon, caecum and terminal ileum are abnormally mobile, which represents failure, in utero, of complete rotation, descent and fixation of the right colon. Patients with acute caecal volvulus present with features of strangulating.