Sigmoid volvulus

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

Abdominal distension.

Patient Data

Age: 85 years
Gender: Female

Supine & upright radiographs

x-ray
Frontal
Frontal
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Info

Classic coffee bean shaped dilated viscus rising up from the pelvis, highly suggestive of sigmoid volvulus.

ct
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

Crisscrossing of the proximal and distal limbs of the sigmoid colon indicates sigmoid volvulus. Whirl sign of sigmoid mesentery best seen on the coronal images. No pneumatosis intestinalis or free air. No bowel wall thickening or focal fluid collection. The small bowel is not dilated.

Case Discussion

Classic example of sigmoid volvulus with characteristic radiographic coffee bean sign and CT whirlpool or whirl sign.

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