Sigmoid volvulus is commonly seen in elderly patients and in those with chronic constipation and mental illness. A long redundant sigmoid colon twists about its mesenteric axis in either direction and forms a closed loop obstruction producing volvulus. A 62-year-old patient reported with abdominal pain, constipation and fever of 2 days duration. The patient was dehydrated and toxic. Abdominal examination revealed massive distension, tenderness and absent bowel sounds. The intraoperative image shows a twisted and enormously dilated sigmoid colon with gangrene (figures 1 and 2). Resection of the gangrenous part with colostomy was done. After 6 weeks the patient had colostomy closure but died on the 3rd day after the operation.

Figure 1

Figures 1 and 2 showing massively dilated sigmoid colon with gangrene

Correspondence to

Imtiaz Ahmed Wani Amira Kadal, Srinagar Kashmir, India, 190009 Cell Phone No. 9419904864 e-mail: imtazwani@yahoo.com