Management of a recurrent sigmoid volvulus in a young patient. Report of a case

Bowel obstruction after large bowel volvulus is a rare cause of acute abdomen. Volvulus of the sigmoid colon occurs more commonly in older, psychiatric or senile patients in prolonged bed rest, but chronic constipation, congenital abnormalities, drug addiction, and surgery also play a role in the etiology. We described a rare case of 21 years-old man who admitted to our hospital with severe abdominal pain, distension and inability to discharge stools. Abdominal computed tomography (CT) revealed a dilated colon with an air-fluid level and the “whirl sign”. On his previous history, he described same attack one year ago which he underwent urgent operation of sigmoidopexy. Our diagnosis was volvulus of the sigmoid and we performed urgent primary resection and anostomosis. Accurate diagnosis and early surgical intervention are essentials for optimal management in sigmoid volvulus. In young and medically fit patients resection and primary anastomosis should be the first choice.