Synchronous caecal and sigmoid volvulus: a surprise twist

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Caecal volvulus (CV) and sigmoid volvulus (SV) are typically considered distinct clinical entities.
• Synchronous occurrence of both CV and SV is exceedingly rare, with limited literature available.

Purpose of the Study:

• To report a rare case of simultaneous caecal and sigmoid volvulus.
• To discuss the diagnostic challenges and implications of this rare presentation.

Main Methods:

• Case report of a patient presenting with symptoms suggestive of sigmoid volvulus.
• Diagnostic workup including plain abdominal X-ray and clinical observation.
• Endoscopic decompression of sigmoid volvulus followed by continued clinical monitoring.

Main Results:

• A rare case of synchronous caecal and sigmoid volvulus was identified.
• Classical 'coffee-bean' sign for SV on X-ray initially masked the concurrent CV.
• Patient's condition deteriorated despite successful endoscopic decompression of SV, prompting further investigation and revealing CV.

Conclusions:

• Synchronous caecal and sigmoid volvulus presents a significant diagnostic challenge.
• Clinical vigilance and a low threshold for re-evaluation are crucial when symptoms persist post-intervention for suspected SV.
• Accurate diagnosis of concurrent volvulus is essential for appropriate management and improved patient outcomes.