title: Imaging, Endoscopic and Genetic Assessment of Marfan Syndrome Presenting with Sigmoid Volvulus: A Review.
abstract: The Marfan syndrome (MFS) is a pleiotropic, autosomal dominant disorder of connective tissue with highly variable clinical manifestations. It primarily involves the skeletal, cardiovascular, and ocular systems; however, gastrointestinal complications are rare. Herein, we describe the case of a 31-year-old male who initially presented with acute abdominal pain for one day. His imaging features revealed a dilated sigmoid colon, consistent with sigmoid volvulus that was immediately decompressed. Surgical resection was recommended to treat the sigmoid volvulus. Preceding the treatment, the patient underwent an extensive workup, including an echocardiography that revealed aortic root dilatation. His clinical history, physical exam, and echocardiographic findings raised the suspicion for MFS. Subsequently, the diagnosis of MFS was confirmed on genetic testing. This is a case that highlights the multidisciplinary (clinical, radiological, endoscopic, molecular/genetic) approach to diagnose a patient with MFS who presented with symptomatic sigmoid volvulus. As this presentation may be a harbinger of more severe manifestations of MFS, it is important to identify it as such in order to accomodate for timely management.
authors.affiliation: Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York City, NY, USA.
authors.forename: Faisal
authors.initials: F
authors.lastname: Inayat
authors.affiliation: Division of Gastroenterology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Abu
authors.initials: A
authors.lastname: Hurairah
authors.affiliation: Imaging Informatics, University of Pittsburgh Medical Center, Pittsburgh, PA. ; Molecular Imaging, Cellsight Technologies, Inc., San Francisco, CA.
authors.forename: Faiq
authors.initials: F
authors.lastname: Shaikh
keywords: endoscopic; genetic; imaging; marfan; sigmoid; volvulus