Ans. (d) Sigmoid colectomy should be performed after confirming diagnosis.Sigmoid volvulus is the diagnosis of the given figure, observe the characteristic bent inner tube or coffee bean appearance, with the convexity of the loop lying in the right upper quadrant (opposite to the site of obstruction). Unless there are signs of gangrene or peritonitis, the initial management of sigmoid volvulus is resuscitation followed by endoscopic detorsion. Detorsion is usually most easily accomplished by using a rigid proctoscope, but a flexible sigmoidoscope or colonoscope may also be effective. Majority of patients are at risk of recurrence (up to 40%). For this reason, an elective sigmoid colectomy should be performed after the patient has been stabilized and undergone an adequate bowel preparation. Clinical evidence of gangrene or perforation is an immediate indication of surgical exploration without an attempt at endoscopic decompression.Image source- style="font-family: Times New Roman, Times, serif">