Sigmoid volvulus in a healthy 25-year-old woman: a case report

Sigmoid volvulus is a rare cause of bowel obstruction in young adults and is classically seen in elderly males. In woman of reproductive age, sigmoid volvulus is easily misdiagnosed as a gynecologic emergency, which will contribute to delayed recognition and increased morbidity. Reports of sigmoid volvulus in healthy young females without predisposing factors remain extremely limited in literature. Against this backdrop of established knowledge, we present a unique case that challenges the typical demographic profile of sigmoid volvulus.

We report a case of a 25-year-old previously healthy Ethiopian woman who presented with progressive abdominal distension, colicky pain, and obstipation. No predisposing anatomic or systemic factors were identified. Despite the absence of advanced imaging modalities such as computed tomography or endoscopy, a clinical suspicion of sigmoid volvulus was raised on the basis of examination findings and the plane abdominal radiography demonstrating the classic "coffee bean" sign. She underwent successful rigid sigmoidoscopic decompression with no complications and remains recurrence free on follow-up.

This case highlights the importance of maintaining a high index of suspicion for sigmoid volvulus in young women presenting with abdominal complaints, even in the absence of typical risk factors. It also illustrates that accurate diagnosis and effective treatment are achieved using basic clinical tools in resource-limited settings, which emphasizes on the role of clinical acumen and basic radiographic tools in resource-limited settings. Clinicians must be aware of this rare but important differential to avoid misattribution to gynecologic conditions and ensure timely intervention.