CASE 294: SIGMOID COLON VOLVULUS, Dr PHAN THANH HẢI- Dr LÊ THỐNG NHẤT, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Male patient 56 yo,  in emergency  going to MEDIC  by  acute  abdominal pain  and  distension. Clinical examination   this  patient cannot lay down ( see foto)

Ultrasound scanning of abdomen  first  detected  colon distension with air  and  hyperperistaltism (see 2 US images).

  

Next step,  a standing X-rays of abdomen was done  with  the  sign of C-loop, typical of  sigma colon  torsion (see   X-rays plain film).

MSCT of abdomen without CE presented  dilated colon  with air   (CT 1 double  black  ring  of  colon sigma distention,   CT 2: image  section of sigma colon  asymmetric,  CT 3:   image of coffee  bean, CT 4 : frontal section  with  mesocolon in torsion).

Radiologist  reported   volvulus of  colon sigma for the case.

Emergency  surgery detected  one part of  sigma colon  ischemic, resection  and colostomy with double canon technique.

Conclusion:  Emergency case  with ultrasound first choice for diagnosis, conventional x-rays  also can help patient  but  CT is the  best  information for this case.