Presentation
Acute pain abdomen with distension and not opened bowels for three days.
Patient Data
Frontal radiograph of abdomen demonstrating hugely dilated hollow viscus, giving a coffee bean appearance, occupying almost entire abdomen with dilated large bowel loops suggestive of sigmoid volvulus. No perforation.
Contrast enhanced CT abdomen pelvis images demonstrating twisting of sigmoid colon around its mesentery with closed loop obstruction and gross dilatation. No signs of ischemia or perforation. The large bowel loops proximal to sigmoid colon are also dilated.
Case Discussion
Sigmoid volvulus is a surgical emergency. Rigid/flexible sigmoidoscopy or colonoscopy are the initial treatment choices. Surgical fixation of sigmoid colon may be considered in later stages.
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