Sigmoid Volvulus

Lee Jia Le, 18, Male, Chinese

On inspection, he is well-conscious, laying
comfortably, no sign of dyspnea.
Sutured wound on his abdominal (It is midline
vertical incision)
This is the first time he has such pain.
(Suspected to be acute and not
chronicimportant to rule out malignancy)
He was presented with sudden onset severe
pain on his abdominal (hypogastric region) and
it is localized pain and no radiation to other
places. The pain is consistent and is
characterized as twisting pain. He used to take a
breath to alleviate the pain but the pain was
slightly reduced. There are no exacerbating
factors. From grade 1 to 10 to scale his
painfulness, he graded it as 10.
He suffered fever, tonsillitis, pharyngitis about 1
week ago before he presented with severe pain
on his center abdominal. He admitted to private
clinic to treat his fever and he forgot the
medication.
He was admitted to Pantai Hospital (21/1/2016)
when he suffered the severe abdominal pain but
he shifted to ampang hospital (22/1/2016) due to
high operation cost.
No past surgical history
No family history
No Smoke, No alcohol, No traveling history. He
did not skipped for his diet but sometimes he
would skip his breakfast.

Drug currently taken

He does not has drug allergy.

1. Cefoperazone
2. Metronidazole
3. Celecoxib
4. Tramadol
5. Mefenamic acid
 6. Metoclopramide HCL
7. Paracetamol (This is the only drug he take in hospital, others he take them at
home)
8. Lactulose
9. Hyoscine N-butyl bromide

VITAL SIGN (TAKEN ON 2/1/2016)

1. PULSE98/MIN
2. RESPIRATION18/MIN
3. BP109/68
4. SPO296%

ABNORMAL TEST(TAKEN ON 2/1/2016)

1. SODIUM132mmol/L
2. CHLORIDE84mmol/L
3. CREA48umol/L

Diagnosis

1. VOLVULUS STRANGULATION
2. TORSION OF COLON
3. INTESTINAL TWIST

MOST REMARKABLESIGMOID VOLVULUS

FYI

1. Blood Group A+
2. He say that he has long colon(large intestine) and Dr Peh suspected that he has
sigmoid volvulus.
3. This is how the sutured wound looked like but in this patient the sutured wound
just under the umbilicus. ( if not mistaken)
4. There is colostomy bag on his left iliac region to store his faeces (not sure for the
location)