Differential Diagnosis for Caecal Volvulus on X-ray

• Single most likely diagnosis
  • Caecal volvulus: This is the most likely diagnosis given the X-ray findings, as caecal volvulus is a condition where the caecum twists around its mesentery, which can be visualized on an X-ray. The twisted loop of the caecum can cause bowel obstruction, and the X-ray is a crucial diagnostic tool for identifying this condition.
• Other Likely diagnoses
  • Sigmoid volvulus: Although the X-ray shows caecal involvement, sigmoid volvulus is another common type of volvulus that can present with similar symptoms and may be considered in the differential diagnosis.
  • Intussusception: This is a condition where a part of the intestine telescopes into another part, which can cause bowel obstruction and may be visible on an X-ray.
  • Adhesional bowel obstruction: This condition occurs when the bowel is obstructed due to adhesions from previous surgeries or other causes, which can present with similar symptoms to caecal volvulus.
• Do Not Miss diagnoses
  • Bowel ischemia or infarction: If the twisted caecum cuts off blood supply to the bowel, it can lead to ischemia or infarction, which is a life-threatening condition that requires immediate attention.
  • Perforation: If the bowel is obstructed and becomes ischemic, it can perforate, leading to peritonitis, which is a medical emergency.
• Rare diagnoses
  • Internal hernia: This is a rare condition where the intestine herniates through a defect in the peritoneal cavity, which can cause bowel obstruction and may be visible on an X-ray.
  • Colonic atresia: This is a rare congenital condition where there is a complete or partial obstruction of the colon, which can present with similar symptoms to caecal volvulus.