LAUSR

volved caecum, a 10 cm upper midline laparotomy was created and a right hemicolectomy performed. Figure 3 shows a dilated right colon after the volvulus was reduced. The terminal ileum is in the right upper quadrant and transverse colon in the right iliac fossa. The patient made an uneventful recovery and was discharged 3 days later. Caecal volvulus accounts for approximately 2% of all causes of adult intestinal obstruction. It presents more in young women, in contrast to sigmoid volvulus that typically affects older men. The incidence of caecal volvulus is reported to range from 3 to 7 people per million per year. Axial torsion of a hypermobile, poorly fixed, caecum can lead to bowel obstruction and strangulation. It was first reported in the literature in the 1830s by Rokitansky. Up to 50% of patients report recurrent, intermittent pain, as in this case. Incomplete rotation of the intestine during fetal development results in incomplete fixation and gut malrotation. This can contribute to a mobile caecum that may then rotate. However, the coexistence of these events has not been widely reported in the literature. This rare case highlights the atypical presentation of a caecal volvulus associated with a malrotated gut.