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Volvulus sigmoid — ABEM Board MCQ

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ModerateGI/Abdominal emergenciesVolvulus sigmoidABEM Board

A 81-year-old nursing-home resident arrives with marked abdominal distention and constipation. Triage acuity is ESI 3; BP 128/70 mm Hg, HR 100/min. Abdomen is tympanitic but not peritonitic. Plain film shows a massively dilated loop arising from the pelvis with a coffee-bean shape. Which of the following is the most appropriate imaging study?

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Correct answer: A — CT abdomen and pelvis to confirm sigmoid volvulus and assess ischemia

Sigmoid volvulus is suggested by coffee-bean dilation; CT helps confirm diagnosis and identify ischemia or perforation before decompression.

Reference: ASCRS volvulus guidance