August 4, 1978

Painless Chronic Sigmoid Volvulus

Author Affiliations

From the Department of Surgery (Drs Verheyden and Beart) and the Division of Gastroenterology and Internal Medicine (Dr Newcomer), Mayo Clinic and Mayo Foundation, Rochester, Minn.

JAMA. 1978;240(5):464-465. doi:10.1001/jama.1978.03290050054020

CHRONIC painless sigmoid volvulus apparently has not been described previously. We recently encountered a patient who complained of chronic constipation without recurrent episodes of pain or bowel obstruction. Barium enema examination together with surgical exploration confirmed the presence of chronic sigmoid volvulus associated with megacolon and chronic constipation. We present this case to broaden the spectrum of symptoms that can occur in patients with sigmoid volvulus.

Report of a Case  A 59-year-old man was referred to the Mayo Clinic for evaluation of possible Hirschsprung's disease. He recalled having been constipated since childhood. The problem had been controlled with enemas, initially one each month but gradually progressing to two or three weekly. In the past five years, he had also taken cathartics with increasing frequency. At the time of his admission he was having one bowel movement each week with the aid of enemas and large doses of milk of magnesia.