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Sigmoid Volvulus


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Sigmoid Volvulus

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins

This is a patient who presented with severe abdominal pain. Frontal radiographs of the abdomen were obtained which demonstrate a markedly dilated loop of large bowel extending from the left lower quadrant into the right upper quadrant of the abdomen. This configuration of the colon is suspicious for a sigmoid volvulus. This is a type of closed loop obstruction where the sigmoid colon twists on its mesentery and results in an obstruction. A CT of the abdomen was acquired to confirm the site of obstruction. The red arrows on the coronal CT image demonstrate a focally collapsed and twisted loop of sigmoid colon in the left lower quadrant as the site of obstruction with marked upstream dilatation of the colon.