Imaging Case of the Week 243 Answer

The scout film shows severe dilatation of the sigmoid colon arising from the pelvis and extending to the right upper quadrant. The three lines from the twisted sigmoid are converging in the left iliac fossa, giving rise to the Coffee Bean sign.

This patient had a rectal tube deflation of the sigmoid volvulus.

Reference: Fundamentals of Diagnostic Radiology by Brant and Helms, 4th Edition.