EC Clinical and Medical Case Reports

Sigmoid volvulus is a well-recognized cause of large bowel obstruction, most commonly occurring in elderly or institutionalized patients with predisposing anatomical factors. Congenital fibrous bands are an exceptionally rare cause of sigmoid volvulus in adults, particularly in individuals with a surgically virgin abdomen. We report the case of a 55-year-old man presenting with acute intestinal obstruction. Contrast-enhanced computed tomography (CT) demonstrated a markedly distended sigmoid colon with the characteristic coffee bean sign and a transition point suggestive of volvulus, without evidence of bowel ischemia. Emergency laparotomy revealed a sigmoid volvulus caused by a congenital fibrous band associated with dolichocolon. Division of the band followed by segmental sigmoidectomy with primary colorectal anastomosis resulted in an uneventful postoperative recovery. This case highlights the diagnostic value of CT in identifying uncommon mechanical causes of sigmoid volvulus and emphasizes that congenital fibrous bands should be considered in adults presenting with bowel obstruction despite the absence of previous abdominal surgery.

Keywords: Sigmoid Volvulus; Congenital Fibrous Band; Dolichocolon; Virgin Abdomen; Computed Tomography; Large Bowel Obstruction

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