Case history
Case history
A man in his early 70s presents with acute-onset, colicky, lower abdominal pain and distension, failing to pass flatus or faeces in the preceding 12 to 24 hours. He reports a recent change in his bowel habit with increased frequency of defecation, some weight loss, and the passage of blood mixed with his stools. On examination he is generally unwell, is pyrexial, and has a distended tympanic abdomen along the distribution of the large bowel, with tenderness in the right lower quadrant. He has an empty rectum on digital rectal examination.
Other presentations
Colonic volvulus predominantly affects older, frail patients.[1][2] It is characterised by an abrupt onset of symptoms, as opposed to other causes, where symptoms present more gradually.[3][4] In patients with rare causes, onset of change in bowel habit varies according to the underlying cause.
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