Acute intrathoracic sigmoid volvulus in major congenital diaphragmatic eventration: a rare thoracoabdominal emergency in an 18-year-old.

Acute intrathoracic sigmoid volvulus secondary to major congenital atic eventration in an adult is exceptionally rare. We report the case of an 18-year-old male with lifelong constipation who presented an acute bowel obstruction caused by intra thoracic sigmoid volvulus in major left diaphragmatic eventration. Despite complete functional loss of the left lung, the patient had no significant respiratory complaints. Emergency endoscopic decompression was performed, followed by sigmoidectomy and diaphragm plication, preventing recurrence of volvulus and improving respiratory function. This case highlights that longstanding constipation and subtle respiratory limitation since childhood were warning signs that could have prompted earlier diagnosis and management of diaphragmatic eventration, potentially preventing the acute presentation.