METHODS: 27 years old Asian Pakistani female presented with worsening abdominal distention, constipation and vomiting since 2 days. On examination she was afebrile, vitally stable. Abdomen was distended, tympanic percussion with generalized tenderness. Abdominal radiograph was obtained which showed dilated bowel loops followed by Computed tomography of abdomen which was suggestive of Sigmoid volvulus causing intestinal obstruction. Patient was immediately moved to endoscopy unit and endoscopic detorsion of volvulus was done. For individuals who present with sigmoid volvulus and do not exhibit signs of peritonitis or colonic gangrene, the recommended course of action involves acute endoscopic detorsion, followed by scheduled surgical intervention.
CONCLUSIONS: This case report emphasizes the significance of clinicians considering sigmoid volvulus as a rare but important cause when evaluating abdominal pain in young and otherwise healthy patients. A delay in diagnosis and treatment extending beyond 48 hours leads to colonic necrosis, amplifying the associated morbidity and mortality. Swift intervention is imperative to mitigate these complications and attain a conclusive remedy.
方法:27岁亚裔巴基斯坦女性出现腹胀恶化,便秘和呕吐2天以来。经检查,她发烧了,非常稳定。腹部扩张,鼓室敲击伴全身压痛。获得腹部X线片,显示肠loop扩张,然后进行腹部计算机断层扫描,提示乙状结肠扭转引起肠梗阻。患者立即转移到内窥镜检查单元,并进行内窥镜扭转。对于出现乙状结肠扭转且未出现腹膜炎或结肠坏疽迹象的个体,推荐的行动方案包括急性内镜下的扭转术,其次是预定的手术干预。
结论:本病例报告强调了临床医生在评估年轻和其他健康患者腹痛时将乙状结肠扭转视为一种罕见但重要的原因的重要性。诊断和治疗延迟超过48小时会导致结肠坏死,放大相关的发病率和死亡率。迅速的干预对于减轻这些并发症并获得决定性的补救措施至关重要。