Presentation
Acute lower abdominal pain.
Patient Data
A dilated haustra-containing bowel loop, more than 6 cm in diameter, extends from the pelvis toward the upper abdomen, with part of it appearing over the liver shadow ("liver overlap sign") approaching to a level above the transverse colon shadow ("northern exposure sign"), along with convergence of the prominent bowel wall lines into the left pelvis (overall making the "coffee bean sign"), and distal descending colon shadow gradual tapering.
The shadows of descending, transverse, and ascending colon are otherwise within normal appearance in general.
No air shadow in the rectal area.
No evidences of small bowel dilatation.
No definite signs of pneumoperitoneum.
Case Discussion
Radiographic features are those of closed loop dilatation of the sigmoid colon, typical for a volvulus, mostly relatively early in the course (in correlation with clinical features and no other bowel loops involved in dilatation, or pneumoperitoneum).
CT study was done (not available) and surgery confirmed the diagnosis.
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