DOI: https://doi.org/10.36347/sasjs.2026.v12i01.016

Pages: 96-99

Sigmoid volvulus is a frequent cause of acute colonic obstruction. Its association with an underlying colonic tumor is rare but clinically significant, as it directly influences therapeutic decision-making. We report the case of a patient admitted to the emergency department with acute intestinal obstruction. Surgical exploration revealed a clockwise sigmoid volvulus associated with a tumoral, sub-stenosing thickening of the twisted bowel loop. An oncologic sigmoid resection with Hartmann’s colostomy was performed. Histopathological examination confirmed the neoplastic nature of the lesion. The postoperative course was uneventful, and the patient was referred for further oncologic management. The association between sigmoid volvulus and colorectal cancer is exceptional and rarely reported in the literature. The presence of an underlying tumor modifies surgical management, requiring an oncologic resection in accordance with oncological principles. Hartmann’s procedure represents a safe option in emergency settings, particularly in cases of significant colonic distension, unprepared bowel, or impaired general condition. This case highlights the importance of suspecting an underlying tumoral etiology in cases of sigmoid volvulus, especially in the presence of atypical features. Appropriate surgical management and increased vigilance are essential to optimize prognosis and ensure adequate oncologic treatment.