RECURRENT SIGMOID VOLVULUS: A CASE REPORT

Abstract

A 16 year old boy came with C/O abdominal pain for 2 days. H/o abdominal distension for 2 days. H/o vomiting for 2 days. H/o obstipation for 2 days. No h/o fever and loose stools. No H/o trauma. No H/o hiccups and breathlessness. No H/o jaundice, haemetemesis and malena. Patient was previously treated with laparotomy and sigmoidopexy for sigmoid volvulus 6 months back. No h/o any comorbids and psychotropic drugs abuse. On examination abdomen is distended. Umbilicus in midline. All quadrants moves with respiration. Midline laparotomy scar- present. No sinuses and distended dilated veins. No mass visible and no VGP and VIP. On palpation not warm, diffuse tenderness is present. Abdomen is soft, guarding is present. No rigidity. No other mass palpable. No hepato splenomegaly. No fluid thrill. On percussion – tympanitic in resonance. No obliteration of liver dullness. On auscultation no bowel sounds heard. On per rectal examination – no fecal staining and no other masses palpable. On investigation X ray showed classical- coffee bean appearance. CT abdomen showed sigmoid volvulus. Patient was proceeded with emergency laparotomy with sigmoidectomy and end to end anastomosis was done. Post op period was uneventful. Patient started on orals on POD-6 and discharged on POD-12.