To report a case of sigmoid volvulus in a previously healthy young adult, emphasizing the diagnostic and management challenges, and noting the incidental finding of enterobiasis in the context of family history.
Approach:
Case Presentation: A 24-year-old Saudi woman presented with 2 weeks of intermittent colicky abdominal pain, low-volume diarrhea, and a final acute episode of severe pain with progressive abdominal distension. She was managed with colonoscopic detorsion followed by laparoscopic sigmoidectomy.
Key Findings:
The patient had a markedly dilated sigmoid colon with imaging consistent with sigmoid volvulus.
An adult Enterobius vermicularis was retrieved during endoscopy, coinciding with a similar diagnosis in her sister.
Histopathology showed ischemic-type changes but viable resection margins.
Interpretation:
Sigmoid volvulus can occur in young adults without classical risk factors, and the incidental finding of enterobiasis should not be overstated in terms of causality.
Limitations:
The case is based on a single patient, limiting generalizability to broader populations.
The relationship between enterobiasis and sigmoid volvulus remains speculative and requires further investigation.
Conclusion:
A two-stage strategy of colonoscopic detorsion followed by laparoscopic sigmoidectomy is feasible in stable patients without ischemia.
