This is a patient who presented with severe abdominal pain. Frontal radiographs of the abdomen were obtained which demonstrate a markedly dilated loop of large bowel extending from the left lower quadrant into the right upper quadrant of the abdomen. This configuration of the colon is suspicious for a sigmoid volvulus. This is a type of closed loop obstruction where the sigmoid colon twists on its mesentery and results in an obstruction. A CT of the abdomen was acquired to confirm the site of obstruction. The red arrows on the coronal CT image demonstrate a focally collapsed and twisted loop of sigmoid colon in the left lower quadrant as the site of obstruction with marked upstream dilatation of the colon.