Chronic Constipation Led This Young Woman to Seek Medical Care — Her X-Ray Told a Surprising Story
Constipation is usually uncomfortable rather than dangerous. A few days of infrequent bowel movements, hard stools, or straining can often be related to diet, dehydration, medications, changes in routine, or lack of physical activity.
But when constipation becomes severe—especially when it occurs together with progressive abdominal swelling and significant pain—it can sometimes point to a much more serious problem.
One published medical case illustrates this dramatically: a previously healthy 33-year-old woman went to the emergency department after experiencing constipation, increasing abdominal distension, and abdominal pain. What initially appeared on an X-ray to resemble a stool blockage turned out to be something very different. Further imaging revealed a sigmoid volvulus, a twisting of part of the large intestine that can cause a dangerous bowel obstruction.
The Case That Surprised Doctors
According to the case report published in The Journal of Emergency Medicine, the woman had experienced the combination of constipation, progressive abdominal fullness, and diffuse abdominal pain for three days.
She was young and previously healthy—making the eventual diagnosis particularly unusual.
Her initial plain abdominal X-ray could resemble fecal impaction, a condition in which hard stool becomes stuck in the rectum or colon. However, a CT scan provided the crucial clue: it showed the characteristic findings of a sigmoid volvulus, including the “coffee bean” and “whirl” signs.
Doctors subsequently found that her sigmoid colon was unusually elongated and had twisted around the tissue supporting it. The bowel was then successfully untwisted and stabilized.
The case is a reminder that not every episode of severe constipation is simply a buildup of stool.
What Is a Sigmoid Volvulus?
A volvulus occurs when part of the intestine twists around the tissue that holds it in place.
When this happens in the sigmoid colon—the lower portion of the large intestine—it is called a sigmoid volvulus.
The twisting can block the passage of stool and gas. More seriously, it can restrict blood flow to the affected portion of the bowel. If blood supply is severely compromised, the intestinal tissue can become damaged or die, potentially leading to perforation, peritonitis, sepsis, or shock.
That is why a suspected volvulus requires prompt medical attention.
Why Can It Happen?
Sigmoid volvulus is more commonly seen in older adults, particularly people with chronic constipation and certain medical or neurological conditions. However, younger people can develop it as well.
One important anatomical factor is a long or unusually mobile sigmoid colon. This can provide more opportunity for the bowel to twist. Chronic constipation may also be associated with an increased risk.
Several published case reports have documented sigmoid volvulus in young women, demonstrating that age alone does not completely rule out the condition. For example, a 28-year-old healthy woman developed constipation and abdominal pain that progressed to vomiting and severe pain; CT imaging identified sigmoid volvulus, and she required emergency surgery.
A more recent 2026 case report also described sigmoid volvulus in a previously healthy young woman, again highlighting how unusual presentations can make diagnosis more difficult.
