Cecal dilatation and volvulus

Dilatation or volvulus of the cecum is the principal differential diagnostic ruleout for cows with an area of tympanitic resonance centered over the right paralumbar fossa. Because passage of digesta between the cecum and the ascending colon is not impeded by the presence of a cecocolic valve or constriction, distention of the cecum invariably results in concurrent dilatation of the proximal loop of the ascending colon (proximal colon) or portions of the spiral or distal loops of the ascending colon. Dilatation of the cecum is a condition of mild severity and may be asymptomatic, with the diagnosis being made during routine examination of the cow for other purposes. The cecum becomes distended with gas and expands into the pelvic inlet with the apex directed caudally. In contrast, volvulus of the cecum is an acute, life-threatening condition characterized by abdominal distention, absence of feces, colic, and death if untreated. In this condition, the cecum and (usually) the first two segments of the proximal colon twist about the mesentery causing incarceration and eventually strangulation obstruction of the affected portions of the bowel. True cecal torsion; that is, twisting of the cecum on its longitudinal axis, is rare. Usually, reports of cecal torsion should be described more accurately as volvulus.