Sigmoid volvulus

Case contributed by Huy Sruy
Diagnosis certain

Presentation

Diffuse abdominal pain, distension and constipation for 3 days.

Patient Data

Age: 90 years
Gender: Male

Abdominal radiograph

x-ray
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Info

Coffee bean sign with large bowel dilatation and absence of gas in the rectum.

CT Abdomen and pelvis

ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal
non-contrast
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal
non-contrast
This study is a stack
Sagittal C+ portal
venous phase
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Info

Prominent sigmoid dilatation with a sudden transition point. Twisting of the sigmoid mesentery and mesenteric vessels consistent a whirlpool sign. The upstream colon is also distended. 

Case Discussion

Sigmoid volvulus is most frequent volvulus in the gastrointestinal tract and commonly seen in elderly patients. 

This patient presented with abdominal pain, distention, and constipation.

Surgery is usually performed when there are features of bowel ischaemia or failure of sigmoidoscopic reduction of the volvulus.

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