Incidental sigmoid volvulus after ground-level fall: an unusual case report

Sigmoid volvulus is an emergency that may cause bowel ischemia, necrosis, and mortality. It usually happens in patients with chronic constipation, narrow mesentery, previous abdominal surgery, prolonged bed rest, and rarely blunt abdominal trauma. We present a rare 80-year-old male patient who came for emergency service trauma service after same-level falls. The patient had no abdominal pain, previous abdominal surgery history, and known disease history. Pelvis x-ray showed femoral neck fracture and suspicion for volvulus. The emergency medicine team ordered an abdominal plain X-ray to rule out the volvulus. Then, the sigmoid volvulus was diagnosed by abdominal X-ray and computed tomography. The patient was transferred to the operation room and underwent sigmoid colon resection and colostomy then was discharged uneventfully. Why should an emergency physician be aware of this? Although a trauma patient may come without abdominal pain, the emergency physician should examine him/her carefully and be suspicious of unrelated conditions.