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Abdominal pain in older adults (OA) is a challenge due to the physiological changes of aging, atypical clinical manifestations, and multimorbidity. The objective is to present an OA patient with a rare etiology of abdominal pain and intestinal obstruction, such as intestinal volvulus. An 82-year-old patient with multiple geriatric conditions is presented, who was admitted for subacute abdominal pain and symptoms suggestive of intestinal obstruction. Computed axial tomography of the abdomen shows the swirl sign compatible with a diagnosis of volvulus of the distal ileum. [ABSTRACT FROM AUTHOR]