The sigmoid colon is the most common site of volvulus of the large bowel. The diagnosis is usually made from the clinical findings and roentgen study of the abdomen; barium-enema examination is not, as a rule, necessary. The characteristic radiologic appearance of this closed-loop variety of colonic obstruction has been well documented (5, 6, 12–15). Its mortality rate has been high, and death is frequently associated with gangrene of the involved segment of the sigmoid. The usual treatment is surgical, but rectal intubation with sigmoidoscopy has been recommended for cases without evidence, proctoscopically, of circulatory embarrassment (1). Although there are numerous reports of the aspect of sigmoid volvulus on barium-enema examination, we have come across none on the appearance soon after detorsion of the volvulus. This is a report of a patient with sigmoid volvulus treated by intubation through a sigmoidoscope. Barium-enema study three days after the detorsion demonstrated striking changes in the sigmoid colon. Case Report B. H., 78-year-old white female, was admitted to the Bronx Municipal Hospital Center on Dec. 1, 1959, with a four-day history of abdominal pain and distention, without vomiting. She had passed no flatus for two days and had only a small bowel movement the day before admission. There was no history of melena or hematemesis. Anorexia had been present for one day. After admission to the hospital, films of the abdomen demonstrated the typical appearance of sigmoid volvulus (Fig. 1). A sigmoidoscope was passed to 20 cm. where a “constricting mass”was encountered in the bowel. As the instrument was passed through the narrowed area, a large amount of gas and watery stool was evacuated, with subsequent subsidence of the abdominal distention and pain. Three days later a barium-enema examination was performed (Figs. 2–4), demonstrating a wide and redundant loop of sigmoid colon with multiple serrations along its borders, having the appearance of numerous small ulcers. The postevacuation film showed pronounced thickening of the sigmoid mucosa. It was believed that these changes represented mucosal edema and ulceration due to circulatory embarrassment at the time of the volvulus. At sigmoidoscopy two days later, however, the sigmoid exhibited only mild injection of the mucosa with no evidence of ulceration. The patient did well and was discharged on a low residue diet. One month after the first admission, a similar episode led to an elective resection of a huge redundant loop of dilated sigmoid colon. Gross and microscopic study of the resected specimen showed only minimal signs of venous stasis. There was mild congestion of the subserosal and submucosal venules. A small amount of proteinaceous hyalinestaining material was present in somewhat dilated lymphatics.