38 yrs male
pain in abdomen for 3 days with differential abdominal distension more in LIF
Associated with constipation and nausea
p/h/o open appendectomy 15 yrs back from RIF incision..
USG : S/O volvulus of sigmoid colon
X RAY: S/O volvulus of colon arising from pelvis with few more air fluid levels
suspected diagnosis: Sigmoid Volvulus..
Sigmoidoscopy: normal...
CECT : Large bowel obstruction with ? p/o Malrotation with kink midway ? cecal volvulus..with diameter of colon . >10 cm.. and dilated proximal bowel loops..
SURGERY: (Exploratory Laparotomy): Derotation, untwisting and division of a LAD Band and repositioning of cecum in left iliac fossa (as this is a case of complete intestinal malrotation type 3) and decompression.
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