PMC4701803_01
An abdominal X-ray shows the coffee bean sign. The diagnosis is sigmoid volvulus.
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An abdominal X-ray showed the coffee bean sign (Fig. 1).
The sigmoid volvulus has been repositioned under radiographic contrast enema, the optimum points of the sigmoidopexy determined, and metal markers placed at these points.
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AI, Olympus Medical Systems, Tokyo, Japan) (Fig. 2). After the reposition, we administered polyethylene glycol lavage via a naso-gastric tube for one day for mechanical bowel preparation. As we did not perform prophylactic urinary bladder catheterization, we administered cefmetazole (1 g) for prophylaxis before and after the procedure, 1% Xylocaine for local anesthesia and flunitrazepam (0.4 mg) for sedation.
Sigmoidopexy has been performed with the Ideal PEG kit (Olympus Medical Systems, Tokyo, Japan) under colonoscopy. The fixation knots are buried subcutaneously.
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The same PEG kit and fixation technique were used for all six points. The fixation knots were buried subcutaneously (Fig. 3).