Sigmoid Volvulus
- 1 December 2010
- journal article
- review article
- Published by AVES YAYINCILIK A.Ş. in Eurasian Journal of Medicine
- Vol. 42 (3), 142-147
- https://doi.org/10.5152/eajm.2010.39
Abstract
In sigmoid volvulus (SV), the sigmoid colon wraps around itself and its mesentery. SV accounts for 2% to 50% of all colonic obstructions and has an interesting geographic dispersion. SV generally affects adults, and it is more common in males. The etiology of SV is multifactorial and controversial; the main symptoms are abdominal pain, distention, and constipation, while the main signs are abdominal distention and tenderness. Routine laboratory findings are not pathognomonic: Plain abdominal X-ray radiographs show a dilated sigmoid colon and multiple small or large intestinal air-fluid levels, and abdominal CT and MRI demonstrate a whirled sigmoid mesentery. Flexible endoscopy shows a spiral sphincter-like twist of the mucosa. The diagnosis of SV is established by clinical, radiological, endoscopic, and sometimes operative findings. Although flexible endoscopic detorsion is advocated as the primary treatment choice, emergency surgery is required for patients who present with peritonitis, bowel gangrene, or perforation or for patients whose non-operative treatment is unsuccessful. Although emergency surgery includes various non-definitive or definitive procedures, resection with primary anastomosis is the most commonly recommended procedure. After a successful non-operative detorsion, elective sigmoid resection and anastomosis is recommended. The overall mortality is 10% to 50%, while the overall morbidity is 6% to 24%.Abstract available from the publisher.Keywords
This publication has 46 references indexed in Scilit:
- Volvulus of the sigmoid colonColorectal Disease, 2010
- Unusual “twister”-like appearance of a sigmoid volvulus on computed tomographyEndoscopy, 2007
- Gastrointestinal: Sigmoid volvulusJournal of Gastroenterology and Hepatology, 2005
- Sigmoid volvulus complicating pregnancyIndian Journal of Medical Sciences, 2005
- The ethics of surgery in the elderly demented patient with bowel obstructionJournal of Medical Ethics, 2002
- Emptiness of the left iliac fossa: a new clinical sign of sigmoid volvulusPublished by Oxford University Press (OUP) ,2000
- Sigmoid volvulus in children and adolescentsJournal of the American College of Surgeons, 2000
- Colonic volvulus in children: value of barium enema for diagnosis and treatment in 14 children.American Journal of Roentgenology, 1994
- Analysis of length and surface area of each segment of the large intestine according to age, sex and physiqueSurgical and Radiologic Anatomy, 1992
- Colonoscopy in the emergency treatment of colonic volvulus in NigeriaDiseases of the Colon & Rectum, 1985