CT
Axial rectal contrast
Coronal rectal contrast
What CT signs are present?
(1) Whirl sign of the sigmoid mesentery and (2) beak sign of rectal contrast reaching the point of obstruction.
How are sigmoid volvuluses normally treated?
Decompression with a rectal tube is successful in 90% of cases.
Grossly dilated loop of sigmoid colon with whirl sign of the sigmoid mesentery. Fat stranding of the sigmoid mesentery. No mural thickening appreciated. Remainder of the colon and small bowel is unremarkable.
Liver, spleen and pancreas have a normal appearance as for the patient's age and non-contrast study. Cholecystectomy clips. Atrophic kidneys with 1.7 cm hypodensity and 1.1 cm exophytic hypodensity at the left interpolar region. Small volume of perisplenic free fluid. No free gas. Lung bases are clear. Degenerative lumbar spine changes.