Abdominal pain and distention.
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Coffee bean sign on scout. Volvulus of the distal sigmoid colon, best appreciated on the coronal images. Mild mesenteric edema prior to volvulus. Upstream colonic dilation and stool. Afferent loop makes turn but is not twisted or obstructed.
Classic sigmoid volvulus. Notice how much easier it is to see the turning of the volvulus on the coronal reformats. See discussion from the very similar companion case.