Sigmoid volvulus in the young. A case following cesarean section.

Sigmoid volvulus occurs more frequently in the younger patient than is presently thought. It is not infrequent in females. It usually presents with "colicky" abdominal pain, long-standing constipation or obstipation, and increasing distention of several days' duration. A history of similar attacks strengthens the suspicion for this diagnosis. Abdominal x-ray films will usually reveal severe colonic dilation down to a low point in the sigmoid, without gas in the rectum. The classic "horseshoe" sign is seldom seen, but when present, strengthens the diagnosis. Surgical manipulation and pregnancy may be contributing factors. Treatment should be surgical unless contraindicated by specific circumstances.