case_images: PMC11683270_01
case_images: A - The abdominal CT scan revealed a whirl sign and significant distention of the haustral sigmoid loop, measuring 12 cm in diameter with parietal thinning. B - Sigmoid colonic loop with air-fluid level and beak appearance of the efferent limb of volvulus and dilated small bowel with poor contrast effect (Red star: dilated loop)
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case_images: A chest CT scan of the abdomen showed significant aerated distention of the sigmoid colon, reaching a diameter of 12 cm (Fig. 1A), with a visible 'whirl sign' indicating a transition zone. The sigmoid wall appeared dilated, with adjacent twisted colonic segments showing a 'bird's beak' appearance, indicative of a volvulus (Fig. 1B).
case_images: Intraoperative view showing digestive necrosis with gangrenous small intestine.
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case_images: Extra-digestive air bubbles were observed near the transition level, along with moderate intraperitoneal effusion (Fig. 2). We found severe acute necrosis of the sigmoid colon and distal ileum, accompanied by a large volume of putrid ascitic fluid (Fig. 2).
case_images: Intraoperative view of the ileal node (red arrow) around the base of the sigmoid, with necrosis of the twisted segments (8 cm of the small bowl and the sigmoid).
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case_images: The sigmoid was wrapped around the ilium in a clockwise direction, thus creating a type II ileosigmoid node (Fig. 3).