A 30 year old woman came with acute onset generalised abdominal pain
Frontal abdominal radiograph shows a large, dilated, U- shaped loop of colon with a central crease (coffee bean sign). The CT scan of the abdomen shows gaseous distention of the sigmoid colon upto the right subhepatic region, its diameter is about 14 cm. There is an air fluid level in it. The sigmoid colon and rectum distal to the twist are collapsed whereas the descending, transverse and ascending colon are fecal loaded. The operative photograph shows an ischemic sigmoid colon