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Case of the Week 338 
What's the most likely diagnosis?
- 58 year-old male with abdominal pain and constipation
- Pneumoperitoneum
- Emphysematous cystitis
- Diverticulitis
- Gastric dilatation
- Sigmoid volvulus
Additional Image - No additional images
Answer:
5. Sigmoid volvulus
More (Click Discussion Tab)
Sigmoid Volvulus
General Considerations
- Twisting of loop of intestine around its mesenteric attachment site may occur at various sites in the GI tract
- Most commonly: sigmoid & cecum
- Rarely: stomach, small intestine, transverse colon
- Results in partial or complete obstruction
- May also compromise bowel circulation resulting in ischemia
- Sigmoid volvulus most common form of GI tract volvulus
- Accounts for up to 8% of all intestinal obstructions
- Most common in elderly persons (often neurologically impaired)
- Patients almost always have a history of chronic constipation
This Week
58 year-old man with abdominal pain and constipation |
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