Presentation
Patient presented to the emergency department with abdominal distention and constipation.
Patient Data
A twist is seen involving the sigmoid colon and its mesentery (whirl sign) causing proximal distention of sigmoid and large bowel loops measuring up to 14 cm in diameter with air-fluid levelling and surrounding fatty stranding. Also, rectal contrast flow ceases at this twist creating "bird beak sign". Features represent sigmoid volvulus, for surgical correlation.
Dilated bowel loops appear to be causing significant mass effect resulting in displacement of vessels and organs; namely the stomach, spleen and jejunal loops.
Mild abdominopelvic ascites.
No pneumoperitoneum.
Case Discussion
Features are typical of sigmoid volvulus, which is a common cause of large bowel obstruction in the elderly.
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