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Related Experiment Videos

Sigmoid volvulus: diagnostic twists and turns.

Ling Tiah1, Siang Hiong Goh

  • 1Accident and Emergency Department, Changi General Hospital, Singapore, Republic of Singapore. Ling_Tiah@cgh.com.sg

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|March 10, 2006
PubMed
Summary

Sigmoid volvulus is increasingly seen in the elderly, presenting with non-specific symptoms. Early recognition by emergency physicians is crucial to avoid diagnostic delays and improve patient outcomes.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Emergency Medicine

Background:

  • Sigmoid volvulus is a common cause of large bowel obstruction, particularly in the elderly.
  • Clinical presentation can be vague, leading to diagnostic challenges.

Purpose of the Study:

  • To delineate the clinical characteristics of sigmoid volvulus.
  • To identify diagnostic difficulties and potential pitfalls in managing this condition.

Main Methods:

  • Retrospective descriptive study.
  • Analysis of 28 sigmoid volvulus cases over a 5-year period (July 1999 - July 2004).

Main Results:

  • Median age of patients was 74 years, predominantly Chinese.
  • Common symptoms included abdominal distension and pain; the typical triad was rare.

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  • Radiographic signs (coffee-bean sign) were inconsistently present on initial plain radiographs, with CT scans aiding diagnosis.

    • Conclusions:

    • With an aging population, sigmoid volvulus incidence is likely to rise.
    • High clinical suspicion is essential for emergency physicians to prevent delayed diagnosis and treatment.