Sigmoid volvulus in a young patient

The case of an 18-year-old man with sigmoid volvulus and recurrent abdominal pain is presented. He was seen in the emergency department three times in a 4-month period, each time complaining of cramping left lower quadrant pain of one to two hours duration without vomiting or diarrhea. Physical examination on each occasion revealed left lower quadrant tenderness without mass, guarding, or rebound. Radiologic evaluation on the first visit revealed sigmoid volvulus, which was reduced by barium enema. Despite identical clinical presentation on two subsequent occasions, radiologic studies showed no evidence of recurrent volvulus. During the ensuing two years, the patient has had no further symptoms.