Sigmoid volvulus in unusual age group and gender without congenital anomalies: case report

Introduction and importance: Sigmoid volvulus causing bowel obstruction in children and adolescents is rare. Clinical features are often nonspecific, including abdominal pain, vomiting, distension, and failure to pass feces or flatus. A high index of suspicion is vital to avoid diagnostic delays and ensure timely management. Imaging tools such as abdominal X-rays and CT scans support diagnosis. Early intervention prevents complications and improves outcomes. We present a 17-year-old healthy female with sigmoid volvulus successfully diagnosed and treated at our hospital. This case underscores the importance of early recognition and prompt management in achieving favorable outcomes. Case presentation: A 17-year-old Ethiopian female presented with crampy abdominal pain persisting for 4 days. The pain was intermittent, diffuse, non-radiating, and gradually increased in intensity. She reported complete absence of bowel movements and flatus, along with progressive abdominal distension over the past 3 days. During the preceding 2 days, she experienced one to two daily episodes of non-bilious, non-projectile vomiting of recently ingested food. She denied fever, urinary symptoms, or similar prior episodes. There was no history of recent travel, trauma, chronic illness, or previous abdominal surgery. Clinical discussion: Sigmoid volvulus is a rare cause of intestinal obstruction in children and adolescents. A high index of suspicion is crucial for timely diagnosis and appropriate management. Delayed recognition can lead to serious complications, including necrosis and perforation of the affected segment of the colon. Conclusion: Although sigmoid volvulus is a rare cause of bowel obstruction in the pediatric age group, it should be considered a potential etiology in patients presenting with an acute abdomen. Given the nonspecific nature of its clinical presentation, a high degree of clinical suspicion is essential for improving patient outcomes.