A case of Sigmoid Volvulus with Cecal Volvulus

Abstract

A 64-year-old man whose medical history included psychogenetic disorder and Parkinson’s disease was referred to our hospital because of abdominal pain, vomitus and fever. Physical examination revealed abdominal defence. Plain abdominal X-ray examination showed a giant colonic gas shadow in the whole lower abdomen. Plain abdominal CT showed extension of the sigmoid colon. Therefore we diagnosed sigmoid volvulus and performed emergency surgery. Intraoperative findings revealed the existence of not only sigmoid volvulus but also cecal volvulus, so we performed Hartmann’s operation and ileocecal resection. The patient recovered once, but ileus recurred times, and 66 days after surgery, he died. Sigmoid volvulus complicated by cecal volvulus is very rare, and to the best of our knowledge no case has been reported in which both diseases occurred and the patient underwent the operation for them simultaneously. Both diseases often occur in elderly patients whose ADL has weakened. Abdominal X-ray and CT are effective for a diagnosis. Intestinal necrosis often occurs, and urgent diagnosis and treatment are required.