Presentation
Intestinal obstruction?
Patient Data
Age: 40 years
Gender: Male
From the case:
Sigmoid volvulus
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The CT scan demonstrates:
- distended colon with a large gas-filled sigmoid colon forming a closed-loop obstruction extending from the pelvis to the left upper quadrant giving the "coffee bean sign"
- crossing loops of bowel at the site of the transition in the upper mid-pelvic region "X-marks-the-spot sign"
- twisting of the sigmoid mesentery and mesenteric vessels giving the "whirlpool appearance"
- minimal intraperitoneal effusion is seen in the pelvis
- no evidence of perforation or bowel ischemia
Case Discussion
The CT features are most consistent with a sigmoid volvulus.