Advertisement

The Reply

  • Junki Mizumoto
    Correspondence
    Requests for reprints should be addressed to Junki Mizumoto, Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyo-ku, Tokyo, 113-0033 Japan.
    Affiliations
    Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Japan
    Search for articles by this author
      I would like to thank Atamanalp, Peksoz, and Disci for their important and thoughtful comment on my case report.
      • Mizumoto J.
      Coffee bean sign detected by visual inspection.
      I agree that the triad is commonly seen in patients with sigmoid volvulus, and that von Wahl sign is rarely seen. I also agree about the importance of computed tomography and endoscopy for the diagnosis.
      Sigmoid volvulus should be treated immediately for outcome improvement. Considering that many medical offices do not have computed tomography or endoscope, and that, if available, it takes times to prepare for these procedures, quick clinical suspicion of sigmoid volvulus still seems to be a challenge. Physicians today often undervalue physical examination
      • Fred HL.
      Hyposkillia: deficiency of clinical skills.
      and skip visual inspection of the abdomen. I believe that knowing the specific physical findings leads to a direct clinical diagnosis and should be considered important in medical education.
      In sum, physicians should be familiar with both common and highly sensitive presentations and rare but specific findings.

      References

        • Mizumoto J.
        Coffee bean sign detected by visual inspection.
        Am J Med. 2021; 134: e388-e389
        • Fred HL.
        Hyposkillia: deficiency of clinical skills.
        Tex Heart Inst J. 2005; 32: 255-257