Sigmoid volvulus (SV) is extremely rare in young patients with ulcerative colitis (UC). We report a 20-year-old female with UC presenting with recurrent SV without traditional risk factors. Computed tomography (CT) confirmed the diagnosis with a "whirl sign." The patient underwent definitive robotic-assisted anterior resection with inferior mesenteric vessel preservation. Notably, the site of torsion corresponded to the segment most severely affected by UC, suggesting a localized inflammatory mechanism contributing to volvulus formation. This case highlights a potential pathophysiological link between chronic inflammation and colonic torsion, possibly involving neuroinflammatory changes. Clinicians should consider recurrent SV in young UC patients as a potential indicator of segmental motility dysfunction and evaluate the need for definitive surgical management.
Huang et al. (Wed,) studied this question.