Synchronous volvulus of the sigmoid colon and caecum, a very rare cause of large bowel obstruction.

Colonic volvulus usually occurs as a single event that can affect various parts of the colon. The usual sites affected being the sigmoid colon (75%) and the caecum (22%). The phenomenon of multiple sites simultaneously undergoing volvulus is an extremely rare occurrence. Synchronous double colonic volvulus is extremely rare and to the best of our knowledge, this is the 4th reported case of simultaneous sigmoid and caecal volvulus in the English literature. The clinical presentation and the radiological findings are that of large bowel obstruction. Classic radiological findings may not be present or may be overlooked due to its rarity. Treatment of this condition is early surgical intervention to prevent the sequalae of a colonic volvulus and its associated mortality. We report a case of an 80-year-old man with synchronous volvulus of the sigmoid colon and caecum.

Hallazgos tomográficos en la isquemia intestinal / Tomographic findings in the intestinal ischemia

La isquemia mesentérica es una entidad grave, que presenta signos clínicos poco significativos. Antes de la era tomográfica su diagnóstico era presuntivo y el estudio angiográfico confirmatorio. Actualmente con los signos tomográficos se logra realizar un diagnóstico preciso. A fin de ilustrar con casos confirmados los signos tomográficos característicos que se desarrollan en la isquemia intestinal se revisaron 2.800 tomografías de abdomen desde 1993 hasta la fecha, hallándose 11 casos de isquemia intestinal confirmados con la evolución clínica y quirúrgica, dos de ellos con anatomía patológica. Se concluye que la TC es un método fidedigno para diagnosticar y/o confirmar los signos de isquemia intestinal (AU)