Presentation
Abdominal pain and distension.
Patient Data
Age: 30 years
Gender: Male
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The large bowel distended with a dilated loop pointing to the right upper quadrant.
From the case:
Sigmoid volvulus
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Dilated air and fecal matter filled ascending, transverse and descending colon reaching ~ 9 cm in maximum diameter with the transitional zone at the sigmoid colon. At this level there is a bird's beak appearance with swirling of the mesenteric vessels and related loops at that level, a collapsed rectum beyond, with no definite obstructing mass lesion.
Minimal free pelvic fluid.
Case Discussion
It is uncommon to detect sigmoid volvulus in such a young patient.
Rectal tube insertion is successful in treating 90% of cases.
It can lead to closed-loop obstruction, ischemia, perforation, and death.
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