A Case of Intestinal Obstruction due to Synchronous Caecal and Sigmoid Volvulus

Abstract

A 53-year-old man with a history of childhood epilepsy and mental retardation presented to a hospital because of nausea and vomiting. He was diagnosed with intestinal obstruction and treated conservatively by the previous doctor for two days, but his condition became worse and he was referred to our hospital for more detailed examinations. Abdominal plain radiography showed a dilated large intestine and an air fluid level. Contrast-enhanced abdominal computed tomography scan showed remarkable intestinal dilatation ascites, and a whirl sign which suggests intestinal torsion, in the right lower quadrant of abdomen. Intestinal obstruction caused by volvulus was diagnosed and a laparotomy was performed. Intraoperative observation showed a markedly dilated colon with caecal and sigmoid volvulus, and we performed subtotal colectomy. After the surgery, paralytic ileus was prolonged. He was discharged from our hospital approximately three months after the surgery. Intestinal volvulus is a condition in which the intestinal tract is twisted with the mesentery. Intestinal volvulus usually occurs at a single site, and it is rare that multiple torsions occur simultaneously. We report a very rare case of intestinal obstruction due to synchronous caecal and sigmoid volvulus.