Sigmoid volvulus

Case contributed by Dr Huy Sruy

Presentation

Diffuse abdominal pain, distension and constipation for 3 days.

Patient Data

Age: 90 years
Gender: Male

Abdominal radiograph

x_ray

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

CT Abdomen and pelvis

ct

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 ischemia or failure of sigmoidoscopic reduction of the volvulus.

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