Sigmoid colon volvulus


Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon. It is a common cause of bowel obstruction and constipation. It is common in Asia, India and especially South India because of the high fibre diet. It is a very common cause of large bowel obstruction in Peru and Bolivia due to high altitude.

Signs and symptoms

The condition is more common in males and with old age. It is also common in people with chronic constipation and laxative abuse.
It is common in:
In sigmoid, volvulus rotation is always anticlockwise. It requires one and a half rotation to cause vascular obstruction and gangrene which eventually leads to perforation either at the root or at the summit of the sigmoid loop.

Diagnosis

  1. Plain X-ray : coffee bean sign is seen
  2. Contrast enema: bird beak sign
  3. CT scan: shows characteristic whirl pattern
  4. Blood: haematocrit, renal functions, serum electrolytes

    Treatment