Male patient 56 yo, in emergency going to MEDIC by acute abdominal pain and distension. Clinical examination this patient cannot lay down ( see foto)
Ultrasound scanning of abdomen first detected colon distension with air and hyperperistaltism (see 2 US images).
Next step a standing xrays of abdomen was done with the sign C-loop, typical of sigma colon torsion (see xrays plain film).
MSCT of abdomen without CE presented dilated colon with air (CT 1 double black ring of colon sigma distention, CT 2 image section of sigma colon asymmetric, CT3: image of coffee beam, CT 4 : frontal section with mesocolon in torsion).
Radiologist reported volvulus of colon sigma for the case.
Emergency surgery detected one part of sigma colon ischemic, resection and colostomy with double canon technique.
Conclusion: Emergency case with ultrasound first choice for diagnosis, conventional x-rays also can help patient but CT is the best information for this case.