An 80-year-old man was admitted to our hospital with increasing colicky pain and loss of appetite. Abdominal X-ray films revealed gross dilatation of the colon without any characteristic features of volvulus such as the coffee bean sign (Fig. Abdominal computed tomography (CT) revealed a dilated colon with an air/fluid level and the "whirl sign", which represents twisted colon and mesentery (Fig. Subsequent colonoscopy detected and relieved volvulus of the sigmoid co-
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Kikawada et al. (2006) studied this question.
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