Sigmoid volvulus in a young patient

Area of Science:

• Gastroenterology
• Abdominal Surgery

Background:

• Sigmoid volvulus is a rare cause of bowel obstruction, particularly in younger individuals.
• Recurrent sigmoid volvulus presents diagnostic challenges, especially when initial imaging is negative.

Observation:

• An 18-year-old male presented with recurrent, self-limiting left lower quadrant abdominal pain over four months.
• Initial presentation included clinical signs of sigmoid volvulus, confirmed by imaging and reduced via barium enema.

Findings:

• Despite identical symptoms on two subsequent visits, repeat radiologic studies showed no evidence of recurrent sigmoid volvulus.
• The patient remained asymptomatic for two years post-initial presentation and treatment.

Implications:

• This case highlights the potential for transient or intermittent sigmoid volvulus that may not be consistently detected on imaging.
• It underscores the importance of clinical suspicion in diagnosing recurrent sigmoid volvulus, even with negative serial imaging.
• Conservative management or watchful waiting may be considered in select cases of suspected intermittent sigmoid volvulus.