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Dubai Surgical Residents
Figure it out fridays
#37
A 28-year-old man with Down's syndrome, admitted to the emergency department for intense abdominal pain with vomiting and obstipation, evolving for 3 days. On admission, the patient was anxious, asthenic with polypnea and and hypotension. The abdomen distended, tender and tympanic on palpation. Abdominal computed tomography (CT) scan: a whirl sing and significant distension of the sigmoid loop. Emergency laparotomy was done and findings as shown in the image. What is the most accurate diagnosis?
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