Sigmoid volvulus: failed rectal tube decompression
Abdominal pain and distension. Failed improvement following insertion of a rectal tube, ? caecal volvulus
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Rectal tube tip (arrow) sits distal to the whorled appearance (arrow) in the sigmoid mesocolon with abrupt transition in colonic calibre (arrow) indicative of sigmoid volvulus
The rectal tube must be passed beyond the volved segment in order to decompress the bowel. It is usually very apparent to the operator at the time if the procedure is successful as marked gas and copious faecal material erupts from the tube and often around it along the rigid sigmoidoscope!