Marked Bladder Displacement by Dilated Rectosigmoid Colon

A 22-year-old man admitted to the hospital after blunt trauma to the head, neck, flank, and abdomen developed sickle cell crisis, Escnerichia coli sepis, tooth abscesses, and pain in his back and shoulders. Initial examination disclosed a massively dilated colon. A whole-body bone scan and a CT scan of the abdomen and pelvis were performed. Tc-99m HDP delayed bone images demonstrated abnormal uptake in multiple sites and a markedly displaced bladder, which emptied after voiding. The CT scan of the pelvis revealed a dilated stool-filled rectosigmoid displacing the bladder and loops of bowel. The patient refused further evaluation of the dilated colon, which emptied after multiple enemas. He was discharged after treatment for sickle cell crisis, sepsis, and tooth extractions.