Rare Presentation of Sigmoid Volvulus with Perforated Appendicitis-A Case Report from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia

Sigmoid volvulus, primarily affecting males, often leads to large bowel obstruction, with management outcomes contingent upon the patient's initial clinical status. Typically, open or laparoscopic surgery is the preferred treatment, barring instances where conservative management is prioritized, especially for surgically unfit patients. Rectal deflation serves as a conservative option, particularly in emergency outpatient settings, aimed at preparing patients for semi-elective or elective procedures. In a recent case, despite an initially smooth clinical condition, a patient diagnosed with simple sigmoid volvulus failed deflation attempts. Subsequently, surgery was performed on the third-day post-failure, revealing colonic perforation distal to the obstruction and perforated appendicitis. Notably, the cause of the appendicitis remains unclear—whether primary or secondary to the volvulus. Additionally, there are no reported instances of perforated appendicitis as a common complication of sigmoid volvulus.