The steel pan sign of sigmoid volvulus-A case series

Coffee bean sign, steel pan sign and whirl sign in sigmoid volvulus

A 66-year-old man presented with abdominal distension. A plain radiograph showed the coffee bean sign, suggesting sigmoid volvulus (SV). The CT scans disclosed the steel pan sign, the whirl sign, and the beak-shaped transition point, confirming SV. He improved with colonoscopic decompression and detorsion. Characteristic radiographic signs of SV are briefly discussed.

Sigmoid volvulus: a rare but unique complication of enteric fever

We present a case of sigmoid volvulus in a young male patient with culture-proven Salmonella Typhi in the blood which was sensitive to Meropenem and Azithromycin only, presented with fever, vomiting, loose stools, hematochezia, abdominal distention and tenderness with no signs of perforation on erect chest x-ray. Further, radiological imaging showed signs of sigmoid volvulus. An urgent colonic decompression with untwisting of the mesentery was performed. In our case, it can be said that sigmoid volvulus was developed as a complication of multiple drug-resistant strains of Salmonella Typhi. The resistance is acquired by alteration in the genome sequence. Currently, it is important to control such an unknown outbreak of multiple drug-resistant strains of Salmonella Typhi as it is a serious health care issue of disease control and prevention in Pakistan.