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Arch Pediatr Adolesc Med. 2008;162(2):182.

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Denouement and Comment: Sigmoid Volvulus

The radiograph of the abdomen (Figure 1) shows a markedly distended sigmoid colon with an inverted U-shaped appearance; the limbs of the sigmoid loop are directed toward the pelvis, while the other end enters the left upper quadrant. The colonic haustrations are lost. The involved bowel walls are edematous, the contiguous walls forming a dense white line on radiographs surrounded by the curved and dilated gas-filled lumen, resulting in a coffee bean–shaped structure; this is the coffee bean sign.¹ There is "beaking" at the distal end of the sigmoid and minimal gas in the distal sigmoid and rectum. This is the classic radiograph appearance of sigmoid volvulus. In case of a nonspecific plain film, a barium enema can be used. In the first image (Figure 2), barium enters the empty rectum and encounters stenosis, giving rise to a beaklike appearance, the so-called bird's beak or bird-of-prey . . . [Full Text of this Article]

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Arch Pediatr Adolesc Med. 2008;162(2):181.
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