Appropriate treatment of acute sigmoid volvulus in the emergency setting

Figure 1 Flowchart of emergency therapeutic strategy for acute sigmoid volvulus.

Figure 2 Plain abdominal X-ray film obtained in the supine position reveals gross dilatation of the colon.

Figure 3 Computed tomography reveals dilated colon with an air/fluid level, as well as the “whirl sign” composed of mesentery and twisted colon.

Figure 4 Colonoscopic examination shows a perforation with inlaid adipose tissue.