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Comments on the Coffee Bean Sign and Visual Inspection

      To the Editor:
      We read with interest the article by Mizumoto about the coffee bean sign finding on inspection that developed as a result of sigmoid volvulus in an 87-year-old male patient.
      • Mizumoto J
      Coffee bean sign detected by visual inspection.
      It was previously reported that the visibility of peristalsis on inspection was 31.9% in endemic and 7.3% in sporadic areas.
      • Raveenthiran V
      • Madiba TE
      • Atamanalp SS
      • De U
      Volvulus of the sigmoid colon.
      As mentioned by Mizumoto, careful physical examination is important in general surgery practice and can be especially effective in diagnosing elderly patients with debility and neurological disease. Turkey is an endemic region for sigmoid volvulus. We have experienced 10 (5.4%) patients who developed sigmoid volvulus due to Alzheimer's, cerebrovascular disease, and Parkinson's disease.
      • Uylas U
      • Kayaalp C
      Different clinicopathological features of non-elderly sigmoid volvulus patients.
      We also presented to the literature a patient with “von Wahl sign” detected by palpation to raise awareness of this condition.
      • Uylas U
      • Gundogdu R
      • Turgut E
      Von Wahl sign in sigmoid volvulus patient with cerebrovascular disease.
      The von Wahl sign is a valuable palpation finding. As the author mentioned, findings that can be detected by inspection in some patients can also raise awareness about sigmoid volvulus.
      We congratulate the authors for their interesting presentation, and we are curious as to their opinion on our comments.

      References

        • Mizumoto J
        Coffee bean sign detected by visual inspection.
        Am J Med. 2021; 134: e388-e389
        • Raveenthiran V
        • Madiba TE
        • Atamanalp SS
        • De U
        Volvulus of the sigmoid colon.
        Colorectal Dis. 2010; 12: e1-e17
        • Uylas U
        • Kayaalp C
        Different clinicopathological features of non-elderly sigmoid volvulus patients.
        Int J Colorectal Dis. 2020; 35: 1937-1942
        • Uylas U
        • Gundogdu R
        • Turgut E
        Von Wahl sign in sigmoid volvulus patient with cerebrovascular disease.
        Gazi Med J. 2021; 32: 476-478