Case of the Week: Sigmoid Volvulus

I have had many people come with bowel obstructions.  There have been many causes: incarcerated inginal hernias, internal hernias, and malrotations of the bowel.  I when I started the surgery in the 24 year old male below I assumed it was an internal hernia or some sort of band obstruction.  I was shocked when I opened I found a sigmoid volvulus.  This is most commonly seen in elderly people, but can also occur in people that have chronic constipation.  I performed a sigmoid resection on the patient and he did very well with surgery.   

 

A distended Sigmoid Colon, it was twisted twice at it's base

Working on the sigmoid resection