摘要
結腸扭結在長期臥床的年長病人是一個常見的疾病，並且好發在乙狀結腸。盲腸的扭結是第二好發的位置，常會被當作脹氣而延遲診斷及治療，造成盲腸扭結的原因以腹膜的鬆弛降低為主，其次是過長的腸繫膜，而診斷僅需腹部X光便能提供診斷依據。盲腸扭結的治療可以先採用軟式大腸鏡作復位及減壓，但日後復發的機率較高。部分或近全結腸切除並迴腸結腸造口是較好的治療方式，特別在扭結之大腸已有壞死或穿孔之慮時必須採用之術式。本院提供一83歲病患，因長期臥床及泌尿道感染而住院，住院期間因腹脹會診一般外科，腹部X光片及可發現一巨大之擴張腸段，臆斷為盲腸扭結，在緊急剖腹探查中發現結腸已有壞疽，再行部分結腸切除及迴腸結腸造口之後，病患安然返家。盲腸扭結之治療主重及早診斷，再此提出此一個案報告，以作為參考。
並列摘要
Cecal volvulus is a surgical condition which attacks people at mid age and accounts rare cases of intestinal obstruction in adults. This was a 83 years old patient who had a history chronic obstructive pulmonary disease combined pneumonia and chronic respiratory failure. Cecal volvulus developed after the patient suffered from a condition of sepsis. Abdominal plain film showed a kidney- shape close-loop colonic air. Owing to the high mortality of cecal volvulus in the elderly, emergent surgical resection of the twisted cecum and colon was necessary. We did an emergent colectomy and end-to-side ileocecal anastomosis. The colon was not well prepared and minimal stump leakage developed. However, the patient was alive after the emergent surgery. Stump leakage recovery relied on nutritional support. Early diagnosis and surgical intervention with nutritional support was effective.