Metachronous Small Bowel and Sigmoid Volvulus in an Elderly Male: A Case Report

TL;DR

An elderly man experienced two rare intestinal twisting events years apart, highlighting shared risk factors and the importance of early treatment.

Contribution

This case report presents a rare instance of metachronous volvulus in different intestinal segments and identifies potential predisposing factors.

Findings

The patient had ileal volvulus followed years later by sigmoid volvulus.

Computed tomography was valuable for diagnosis.

Early elective sigmoidectomy is recommended to prevent recurrence.

Abstract

Volvulus, torsion of the intestine causing luminal obstruction and vascular compromise, is a surgical emergency most commonly involving the sigmoid colon in adults; small-bowel volvulus (SBV) is less frequent in developed countries. Metachronous volvulus arising in different intestinal segments within the same individual is exceptionally rare. We report an elderly male who underwent emergency surgery for ileal volvulus and, several years later, developed sigmoid volvulus (SB) requiring colectomy. This case highlights a possible shared predisposition (elongated/mobile bowel on a narrow mesenteric base and postsurgical adhesions), underscores the diagnostic value of computed tomography, and supports early elective sigmoidectomy after successful endoscopic detorsion to prevent recurrence and ischemic complications.

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