title: Hemorrhagic shock caused by sigmoid colon volvulus: an autopsy case.
abstract: BACKGROUND
  Many reports have described sigmoid volvulus, but fatal hemorrhagic shock resulting from the rupture of the involved artery has not been reported as a complication of a sigmoid volvulus.
  
  
  METHODS
  A 71-year-old man with slight abdominal pain and obstipation in hypotension died at a nursing home without seeing a doctor. At autopsy, a mesenteric hematoma and hemoperitoneum was observed with approximately 1,000 ml of blood in the abdominal cavity. The sigmoid colon and the mesentery were twisted at an adhesion site of a sigmoid colon to an ileum, and the condition was determined to be a sigmoid volvulus. The volvulus was observed to be loosened. The inferior mesenteric artery was incorporated into the twisted part of the mesentery, but remained patent, and its peripheral branch near the hematoma ruptured without histological abnormality.
  
  
  CONCLUSIONS
  Since ischemic-reperfusion injury occurs with a temporarily occluded artery, the acute re-loading of blood flow may injure the distal vessels after spontaneous reduction of compression by loosening of the volvulus.
authors: Department of Forensic Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
authors: Hiroaki
authors: H
authors: Sato
authors: Toshiko
authors: T
authors: Tanaka
authors: Noriyuki
authors: N
authors: Tanaka
mesh_terms: D000368:Aged; D001344:Autopsy; D001808:Blood Vessels / Q000473:pathology; D012809:Colon, Sigmoid / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D045822:Intestinal Volvulus / Q000150:complications* / Q000473:pathology; D008297:Male; D008638:Mesenteric Arteries / Q000473:pathology; D012421:Rupture; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000473:pathology