Arthritis with sigmoid volvulus and HL-A B27

A 43-year-old male developed seronegative polyarthritis after a short attack of diarrhoea. For about two years before he had experienced intermittent abdominal pain, distension and constipation. Laparotomy showed a chronic sigmoid volvulus for which sigmoid colectomy was performed. Post-operatively he had no further bowel symptoms, no further arthritis and there was radiological improvement of involved joints. Tissue typing showed HL-A B27 antigen.