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Sigmoid volvulus

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

One day of distension and progressive diffuse abdominal pain. Constipation but no fever or vomiting.

Patient Data

Age: 85 years
Gender: Male

Abdomen X-ray

ct

Markedly dilated bowel in the abdomen, with the apex of the dilated loops pointing toward the right upper quadrant.

CT Abdomen and pelvis

ct

There is a markedly dilated sigmoid colon, with an abrupt transition point at the rectosigmoid junction and swirling of the surrounding mesentery and vessels.

Annotated image

Annotated images.

Case Discussion

Sigmoid volvulus is an abnormal twisting of the sigmoid colon along its mesenteric axis that causes closed-loop obstruction and can lead to ischemia, perforation, and death. 

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