Sigmoid volvulus is one relevant cause of large intestine obstruction in adults and a clinically significant cause of abdominal pain ^1-5. A delay in recognizing this condition can lead to ischemia of the bowel wall, necrosis, or perforation, which carries a high mortality ^1-5. CT is the modality of choice to establish this diagnosis ^1-5. Therefore, radiologists should be aware of this disorder because prompt diagnosis is critical to avoid the life-threatening complications of this condition ^1-4.

This case demonstrates a classic CT presentation of sigmoid volvulus. The therapeutic management consisted of a successful decompressive colonoscopy, and the patient recovered well after the operation.