An 89-year-old man with a bulging belly like a ball. For a few days, he didn’t understand how to defecate. When I came to the hospital to do a CT, I found that the colon was significantly expanded, which was 5-6 times normal, and the gas accumulation in the area was obvious. The lengthy and distorted colonic colon, partial beak-like changes, and empty rectum are considered to be twisted with colonic colon obstruction. Emergency endoscopic downward torsion reduction. Torsion of the sigmoid colon is a more common type of colonic stenosis obstruction. The main reason is that the sigmoid colon is lengthy and the mesentery is relatively short, or it is caused by inflammatory adhesions. The colon loop rotates along the long axis of the mesentery with its mesentery as the fixed point, and the intestinal lumen is partially or completely occluded, which is called intestinal torsion. The twist is generally clockwise, and obstruction can occur when the twist is above 180°. Mild torsion can be less than 1 week, and the worst can be 2 to 3 weeks. After onset, on the one hand, intestinal lumen stenosis and obstruction may occur, and strangulation may occur due to compression of mesenteric vessels.