Sigmoid volvulus: An image telling the story

A 77-year-old gentleman, with past medical history of dementia and psychosis, presented to the emergency department with a chief complaint of abdominal distention. X-ray imaging of the abdomen revealed air filled distended loops of large bowel (Figures 1A and 1B). Computerized tomography (CT) revealed marked dilatation of the large intestine, from the cecum to the sigmoid colon where there is a beak-shaped transition as well as multiple air fluid levels without free air (Figures 2a and 2b). A bedside colonoscopic decompression was performed with resolution of the volvulus.

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