A 72-year-old male with a history of Parkinson's disease, Type 2 diabetes, hypertension, hyperlipidemia, and cerebral vascular accident presented to the emergency room for 10 minutes of unresponsiveness at his nursing home. A workup for the unresponsiveness was unrevealing. His hospital course was complicated by constipation, a condition that resulted in multiple hospitalizations in the prior 6 months. Abdominal exam was notable for mild distension, and an initial x-ray demonstrated an ileus. The severity of his distention acutely worsened two days after it was initially noted, and was associated with borborygmi and high-pitched bowel sounds. A repeat x-ray was consistent with a sigmoid volvulus. The patient underwent endoscopic colonic decompression with resolution of the volvulus, but due to recurrence, ultimately required a sigmoidectomy.
Chalikonda, MD, Divya; Lutman, DO, Brian; and Gandler, MD, Alan
"Clinical Images: Sigmoid Volvulus,"
The Medicine Forum: Vol. 18
, Article 5.
Available at: http://jdc.jefferson.edu/tmf/vol18/iss1/5