Coffee bean sign, whirl sign and bird’s beak sign in the diagnosis of sigmoid volvulus
Mehmet Yigit, Kenan Ahmet Turkdogan
The Pan African Medical Journal. 2014;19:56. doi:10.11604/pamj.2014.19.56.5142

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Images in medicine

Coffee bean sign, whirl sign and bird’s beak sign in the diagnosis of sigmoid volvulus

Cite this: The Pan African Medical Journal. 2014;19:56. doi:10.11604/pamj.2014.19.56.5142

Received: 26/07/2014 - Accepted: 01/09/2014 - Published: 23/09/2014

Key words: Coffee bean, sigmoid volvulus, whirl

© Mehmet Yigit et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/19/56/full

Corresponding author: Mehmet Yigit, Bezmialem Vakif University, Department of Emergency Medicine, Istanbul, Turkey (yigitacil@gmail.com)


Coffee bean sign, whirl sign and bird’s beak sign in the diagnosis of sigmoid volvulus

 

Mehmet Yigit1,&, Kenan Ahmet Turkdogan1

 

1Bezmialem Vakif University, Department of Emergency Medicine, Istanbul, Turkey

 

 

&Corresponding author
Mehmet Yigit, Bezmialem Vakif University, Department of Emergency Medicine, Istanbul, Turkey

 

 

Image in medicine

The patient, a 28-year-old man who had presented to our Emergency Department (ED) with constant abdominal pain and distension for one day, had no previous medical or surgical history. He denied that he had any nausea, vomiting, diarrhea or constipation. At admission, his physical examination revealed hypertension (TA: 152/97 mmHg) and a distended abdomen with generalised tenderness and hypoactive bowel sounds. There was no fever, abdominal guarding, rebound or rigidity. Laboratory results were within normal limits. A plain radiograph of the abdomen revealed a “coffee bean” sign. We also observed an impressive picture of a typical “whirl” sign and a “bird’s beak” sign on an emergent abdominal computed tomography (CT) scan. Also, his CT scan revealed marked distension and a twisted loop of sigmoid colon. Sigmoid volvulus (SV) was diagnosed rapidly with these characteristic radiological signs. Subsequently, with flexible sigmoidoscopy, the patient was successfully decompressed and detorsioned. SV is potentially life-threatening and requires emergency intervention. It is the third leading cause of colon obstruction in adults after cancer and diverticulitis. The primary emergency therapy for uncomplicated SV is endoscopic detorsion and decompression. Emergency physicians in particular should be aware of the typical radiographic CT signs, “coffee bean,” “whirl” and “bird’s beak,” which are indicative of SV and which will allow them to easily diagnose this condition in cases of acute abdominal obstruction. If emergency physicians delay diagnosis, the patients might require emergency surgical intervention.

Figure 1: Coffee bean sign (A), whirl sign (B) and bird’s beak sign (C) in the diagnosis of sigmoid volvulus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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