Presentation
Abdominal pain and constipation.
Patient Data
Markedly dilated sigmoid colon reaching the right hypochondrial region showing coffee bean sign, tapering of its lower end (bird beak sign with rectal contrast) and whirly appearance of its mesentery. No underlying mural thickening noted.
Other findings include bulky left supra renal gland, bilateral renal cortical cysts, bilateral inguinal hernias, right Spigelian hernia, spondylodegenerative changes of the lumbar spine and atheromatous plaques of the aorta and iliac vessels.
Surgical specimen confirms the diagnosis of sigmoid volvulus.
Case Discussion
CT is the imaging modality of choice used to assess patient with abdominal pain
CT findings of sigmoid volvulus include; markedly dilated sigmoid colon with coffee bean appearance, smooth tapering of its lower ends (bird peak appearance) and whirl sign of the sigmoid mesentery
CT can help in assessment of bowel ischemia associated with obstruction
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