Sigmoid volvulus

Case contributed by Liter Nguri
Diagnosis almost certain

Presentation

Abdominal distention and pain.

Patient Data

Age: 75 years
Gender: Male
ct

Grossly dilated sigmoid colon (maximum diameter of ~11cm) with twisting of its mesentery seen at the point of obstruction. 

No evidence of bowel ischemia or free abdominal air.

Minimal free fluid is noted in the right subdiaphragmatic recess.

Case Discussion

This case shows typical radiological presentation of sigmoid volvulus:

  • coffee bean appearance of grossly dilated ahoustral large bowel loop seen on CT scout image directed towards the right upper quadrant
  • whirl sign: twisting of the mesentery and mesenteric vessel

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