Sigmoid volvulus

Case contributed by Dr Huy Sruy

Presentation

An elderly patient comes to the hospital with diffuse abdominal pain, distention and constipation for 3 days.

Patient Data

Age: 88
Gender: Male
X-ray

Abdominal radiograph

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

CT

CT Abdomen and pelvis

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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Case information

rID: 59307
Published: 5th Apr 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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