This is a classical case of sigmoid volvulus. The patient presented with severe abdominal pain and distension with inability to pass stools for 2 days and urine for 1 day.

He had consumed antispasmodics with no relief. Patient was admitted and a supine AP view radiograph was taken which revealed dilated bowel loops.

Contrast enhanced CT scan of abdomen was performed which showed the classical radiological signs of sigmoid volvulus.

Within a few hours, the patient was taken up for surgery. Intra-operative image is attached above. Surgery was successful and the patient recovered well.