Sigmoid colon volvulus: A case report

Abstract

Colonic volvulus, specifically sigmoid volvulus, is the third leading cause of large-bowel obstruction after carcinoma and diverticulitis in Western countries. Clinical manifestations are abdominal pain, distention, constipation and vomiting. The coffee bean sign is a classic conventional radiographic finding of sigmoid volvulus. Up to 80% of the patients, sigmoid volvulus can be diagnosed by viewing the supine abdominal radiograph alone. If the supine abdominal radiograph is not definitively diagnostic, barium enema examination should be performed. CT can demonstrate the whirl sign and signs of ischemia. A distended, redundant, transverse colon; cecal volvulus and pseudo-obstruction can mimic sigmoid volvulus. Sigmoid volvulus requires early recognition and treatment. A combination of emergent non surgical decompression and elective sigmoid resection has the lowest mortality rate (% 5-10) among the therapies. If there is evidence of bowel gangrene, urgent resection carries a much higher mortality rate of 50%–70%. We reported a case of sigmoid volvulus in a 85 year old male presented with abdominal pain and distension.