This case demonstrates a sigmoid volvulus and high grade large bowel obstruction in a patient who was successfully decompressed via rigid sigmoidoscopy and rectal tube insertion.

The patient was a high care nursing home resident who relied on a wheelchair for mobility due to spina bifida and hoist transfers for toileting. After discussion with the patient, he underwent a Hartmann's procedure and permanent colostomy formation for definitive management of his volvulus and to assist with long term toileting.