Cecal Volvulus Within the Etiological Spectrum of Intestinal Obstruction in Adults Admitted to General Surgery: A Single-center Retrospective Cohort Study

Aim: To describe the etiological distribution of acute intestinal obstruction among adults admitted to general surgery, the anatomical distribution of volvulus, and the characteristics of the cecal volvulus subgroup. Materials and Methods:Adults admitted to the General Surgery Clinic of University of Health Sciences Türkiye, Ankara Etlik City Hospital, via the emergency department or by direct hospitalization, with acute intestinal obstruction or ileus between October 2022 and October 2025 were retrospectively analyzed.The cohort was classified by etiology, and volvulus cases were categorized as cecal or non-cecal.The cecal volvulus subgroup was analyzed descriptively, without inferential statistics.Results: Among 1.316 patients (696 male; mean age 62.7±18.3years), adhesive ileus was the most common etiology (861, 65.4%), and volvulus was identified in 109 patients (8.3%): 105 non-cecal and 4 cecal.The four cecal volvulus patients were aged 22-83 years; three had a neurological comorbidity.The original computed tomography (CT) report identified cecal volvulus in two patients.One preoperative endoscopic detorsion attempt was unsuccessful.All four underwent open resection; the two with ischemia and necrosis received a stoma, and the other two received a primary anastomosis.One 83-year-old patient died within 90 days from postoperative cardiopulmonary complications. Conclusion:In this cohort of surgically admitted patients with intestinal obstruction, cecal volvulus was uncommon.The descriptive findings in this four-patient subgroup are hypothesis-generating and consistent with recommendations in the literature that the anatomical site of volvulus be explicitly reported on CT.