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Mediastinal and tracheal shift due to recurrent sigmoid volvulus: A case report
Mensur Osman Yasin1, Mezgebu Alemneh Assefa1, Hirut Tesfahun Alemu2
1Department of Surgery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
This case study highlights a rare instance of acute sigmoid volvulus causing a significant mediastinal shift in a farmer. Early surgical intervention and multidisciplinary care are crucial for managing this complex condition.
Area of Science:
- Gastroenterology
- Pulmonology
- Radiology
Background:
- A 70-year-old Ethiopian farmer presented with a 3-day history of acute large bowel obstruction.
- The patient had experienced three similar recurrent episodes over three years, previously managed with rectal tube decompression.
Observation:
- Clinical examination revealed cardiopulmonary distress without peritonitis.
- Plain abdominal and chest X-rays showed sigmoid volvulus with mediastinal shift, elevated diaphragm, and dextrocardia.
Findings:
- Sigmoid resection and end colostomy were performed.
- The patient recovered and was discharged on postoperative day 14.
Implications:
- Acute sigmoid volvulus causing mediastinal shift is a rare presentation.
- Multidisciplinary management involving pulmonologists may be essential for optimal patient care in such atypical cases.
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