Patient from high-care nursing home presents with one day history of abdominal pain, not passing flatus or opening bowels.
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Mechanical large bowel obstruction secondary to sigmoid volvulus, with swirling of the mesentery.
Grossly distended loops of large bowel proximal to volvulus, with the distal sigmoid and rectum collapsed.
The case demonstrates the Whirlpool sign of mechanical bowel obstruction.
As with most sigmoid volvulus, this patient was managed successfully with flexible sigmoidoscopy.