Transverse colon volvulus presenting as 'inverted' coffee-bean sign

A 12-year-old boy with cerebral palsy had a history of fever, diarrhoea and progressive bilious vomiting for 2 days. Physical examination revealed absent bowel sounds and peritoneal sign. An abdominal plain film showed a ‘V-shaped’ loop of the dilated large intestine with the apex pointing ‘downward’ (figure 1), rather than the typical …