Sigmoid volvulus

Case contributed by Dr Prashant Mudgal

Presentation

Young adult presented with abdominal pain and distention.

Patient Data

Age: 21
Gender: Male
X-ray

There is a hugely dilated sigmoid that almost fills the entire abdomen. Note the coffee bean sign also known as bent tyre tube sign, extending from the pelvis to the diaphragm. There is complete loss of haustral pattern. Imaging findings are suggestive of sigmoid volvulus.

CT

Sigmoid colon is grossly overdistened with twisting of sigmoid colon causing resultant closed loop obstruction. The ascending and descending loops of the dilated sigmoid colon are  conversing on the left side of the pelvis with narrowing of the bowel loops, suggestive of volvulus.  The dilated sigmoid is colon is reaching upto the left hemidiaphragm (upto the level of Th11 vertebra). The sigmoid colon diameter measures 11 cm. Whirl sign is noted, representing tension on the tightly twisted mesocolon by the afferent and efferent limbs of the dilated colon.

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Case information

rID: 33903
Case created: 28th Jan 2015
Last edited: 8th Dec 2015
Tag: pm
Inclusion in quiz mode: Included

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