Presentation
Acute onset of abdominal pain with distension, nausea and vomiting.
Patient Data
Age: 35 years
Gender: Male
From the case:
Sigmoid volvulus
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Info
The CT scan demonstrates:
- the colon is distended with a large gas-filled sigmoid colon extending from the pelvis to the left upper quadrant forming a closed-loop obstruction with a "coffee bean sign" well-visualised on coronal lung window
- crossing loops of sigmoid colon at the site of the transition in the left upper paramedian pelvic region "X-marks-the-spot sign"
- twisting of mesenteric vessels and the sigmoid mesentery giving the "whirlpool appearance" with adjacent engorged mesenteric vessels
- no evidence of perforation or bowel ischaemia
- Fatty liver is noted
Case Discussion
The CT features are most consistent with a sigmoid volvulus.
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