Sigmoid volvulus

Case contributed by Faeze Salahshour
Diagnosis certain

Presentation

The patient presents with abdominal pain, distension, and obstipation for 3 days and seems ill.

Patient Data

Age: 60 years
Gender: Male

Abdomen and pelvis

ct
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Info

The dilated sigmoid is seen in the upper abdomen. Twisted sigmoid mesocolon is seen as a whirlpool sign in the left lower abdomen. Fat stranding of sigmoid mesocolon and a focus of absent flow in the sigmoid artery at the site of twisting is seen suggestive of impending strangulation.

Annotated image
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The red arrows follow the course of the sigmoidal artery, with a small focus of absent flow at the site of twisting.

Photograph
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The image shows the pathologic report of the resected sigmoid.

Case Discussion

The patient was ill and went to the operating room and had resection anastomosis of twisted sigmoid, Sigmoid was congested but not yet fully gangrenous.

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