The patient presented with colicky pain throughout the abdomen radiating to the back, with occasional burning sensation in the epigastric region. There was constipation with one episode of vomiting. This presentation was the second such episode; the patient had the same pain 3 years before and was treated conservatively with IV fluids.

On examination: BP:145/84, PR:113, SPO2: 100%, Pain score: 10/10. The abdomen was mildly distended with generalized tenderness and guarding mainly on the left side of the abdomen.
Initial management with IV fluids and analgesia. 

Clinical and imaging features compatible with sigmoid volvulus. A specific CT sign for volvulus is the whirlpool sign, which has been described in volvulus of the midgut, cecum, and sigmoid colon.