Presentation
3 day history of cramping abdominal pain and constipation with a hard distended peritonitic abdomen and no bowel sounds on examination.
Patient Data
A sigmoid volvulus is demonstrated with the whirl sign present. This represents twisting of the sigmoid mesentery and mesenteric vessels. There is significant dilatation of the sigmoid colon, measuring up to 11 cm.
There are multiple renal cortical and exophytic cysts, the largest being a 20 x 16 cm superior pole left renal cyst.
No pneumoperitoneum.
No pneumatosis intestinalis.
No portal venous gas.
Case Discussion
This is a case of sigmoid volvulus resulting in large bowel obstruction.
The whirl sign is readily appreciated on the coronal and axial sequences, highlighting the utility of CT in suspected cases.
Sigmoid volvulus was confirmed during flexible sigmoidoscopy with decompression.
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