Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report

Abstract

Sigmoid volvulus (SV) is an emergency that may cause bowel ischemia, necrosis, and mortality. It usually occurs in patients with chronic constipation, narrow mesentery, previous abdominal surgery, prolonged bed rest, and rarely blunt abdominal trauma. We present the case of a rare 80-year-old male patient who came for emergency service trauma service a same-level fall. The patient had no abdominal pain, previous abdominal surgery history, or known disease history. Pelvis X-ray showed femoral neck fracture and suspicion of volvulus. The emergency medicine team ordered an abdominal plain X-ray to rule out volvulus. The SV was diagnosed by abdominal X-ray and computed tomography. The patient was transferred to the operating room and underwent sigmoid colon resection and colostomy, and was discharged uneventfully. Why should an emergency physician be aware of this? Although a trauma patient may come without abdominal pain, the emergency physician should carefully examine him/her and be suspicious of unrelated conditions.