On the Coffee Bean Sign

Sigmoid volvulus is the most common form of volvulus of the gastrointestinal tract; it is responsible for 8% of all intestinal obstructions. Basically, it happens when the sigmoid part of the bowel is rotated, causing the part proximal to the rotation becoming dilated.

On abdominal x-ray, the typical finding is a greatly dilated sigmoid that almost fills the entire abdomen. Note the coffee bean sign. The remainder of the large bowel is not dilated, presumably because the proximal point of the twist is not causing obstruction and thus allows drainage into the sigmoid.

But for some strange reason... this is what I saw.



HOLY CRAP!