Initial Computed Tomography Findings of Long and Distended Colon Are Risk Factors for the Recurrence of Sigmoid Volvulus
- 1 April 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Digestive Diseases and Sciences
- Vol. 66 (4), 1162-1167
- https://doi.org/10.1007/s10620-020-06317-z
Abstract
Background Sigmoid volvulus is a common condition in elderly patients with elongated colons. Although endoscopic de-torsion is effective as the primary treatment of sigmoid volvulus, elective surgery is recommended because of the high risk of recurrence and high mortality rate. Aim The aim of this study was to determine the risk factors for the recurrence of sigmoid volvulus. Methods Clinical records of patients treated at Shimane Prefectural Central Hospital were reviewed retrospectively. Among 41 sigmoid volvulus patients who were successfully treated by endoscopic de-torsion and followed up, 30 were observed over 1 year. Among the 30 patients, eight (26.7%) did not experience recurrence, while 22 (73.3%) did. Initial computed tomography (CT) findings indicating the sigmoid colon extending to the diaphragm or ventral to the liver were defined as "extension findings." Extension findings and sigmoid diameter were evaluated in relation to sigmoid volvulus recurrence. Results Extension findings were significantly more frequent in the recurrent group (77.3%) than in the nonrecurrent group (25.0%) (P = 0.009). Distended sigmoid colon diameter was significantly larger in the recurrent group (11.7 +/- 3.8 cm) than in the nonrecurrent group (7.1 +/- 1.1 cm) (P = 0.044). Receiver operating characteristic curve analysis demonstrated that the performance threshold was greater than 8.9 cm. Kaplan-Meier analysis showed the significantly high sigmoid volvulus recurrence rate in the patients with extension findings and a distended sigmoid colon greater than 8.9 cm. Conclusions CT findings of a long and distended sigmoid colon in initial sigmoid volvulus are risk factors for the recurrence of sigmoid volvulus.This publication has 16 references indexed in Scilit:
- Clinical outcomes of sigmoid colon volvulus: identification of the factors associated with successful endoscopic detorsionIntestinal Research, 2017
- Clinical Practice Guidelines for Colon Volvulus and Acute Colonic Pseudo-ObstructionDiseases of the Colon & Rectum, 2016
- The morphology of the foetal sigmoid colon in the African population: a possible predisposition to sigmoid volvulusColorectal Disease, 2015
- Colonic Volvulus in the United StatesAnnals of Surgery, 2014
- Management of Colonic VolvulusClinics in Colon and Rectal Surgery, 2012
- Sigmoid VolvulusEurasian Journal of Medicine, 2010
- Diagnosis of colonic volvulus: findings on multidetector CT with three-dimensional reconstructionsThe British Journal of Radiology, 2010
- CT Findings of Sigmoid VolvulusAmerican Journal of Roentgenology, 2010
- Radiological anatomy of the sigmoid colonSurgical and Radiologic Anatomy, 2008
- An Algorithm for the Management of Sigmoid Colon Volvulus and the Safety of Primary Resection: Experience with 827 CasesDiseases of the Colon & Rectum, 2007