GI EMERGENCIES · MEMBERSHIP SURGERY

Sigmoid volvulus — 72M, distended abdomen

12 decision points ~22 min Difficulty 3/5 Membership

Setting

You are the surgical registrar on-call at Korle Bu. Endoscopic flexible sigmoidoscopy is available with 1-hour notice. CT and theatre are on-call.

Patient

Mr N, a 72-year-old retired teacher from Aburi, is referred with 3 days of progressive abdominal distension, colicky abdominal pain, absolute constipation and one episode of vomiting today. History of chronic constipation and dependence on laxatives. Vitals BP 128/78, HR 96, temp 37.2. Abdomen grossly distended, tympanic, non-tender, no peritonism. PR: empty ballooned rectum.

Reference stack

Bailey & Love 28e Ch 68 · Sabiston 21e Ch 51 · WSES 2018 colonic volvulus · ASCRS practice parameters 2016

Start cascade →

You'll be asked to decide what happens next at each step. There's no timer — take your time. The correct answer + evidence-anchored rationale is revealed after each choice.