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 (7% of intestinal obstruction) 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.[1]
Contents
1Signs and symptoms
2Cause
3Diagnosis
4Treatment
5References
6External links
Signs and symptoms
Pain in abdomen – initially left-sided, eventually all over
Absolute constipation
Enormous distension of abdomen
Late vomiting and eventually dehydration
Features of peritonitis
Hiccough and retching may occur
Tyre-like feel of the abdomen is diagnostic
Cause
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:
Ogilvie syndrome
Individuals with learning difficulties
Chagas disease
Hypothyroidism
Anticholinergic drugs
Multiple sclerosis
Scleroderma
Parkinson's disease
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
Plain X-ray (diagnostic in 70–80%): coffee bean sign is seen[2]
By flatus tube or sigmoidoscope, derotation is done
If derotation does not occur, then laparotomy through midline incision should be done. It is derotated manually. If viable, it can be fixed to lateral wall of abdomen or pelvis
If sigmoid colon is gangrenous, then Hartmann's operation or Paul Mikulicz operation is done[4]
References
^Sriram Bhat (2012). SRB's Manual of Surgery. JP Medical Ltd. p. 997. ISBN 9789350259443.
^Jaypee Brothers (2007). Srb's Manual of Surgery by Bhat. Jaypee Brothers Publishers. p. 583. ISBN 9788180618475.
…The goal of treatment of sigmoid volvulus is to reduce the sigmoid volvulus and to prevent recurrent episodes. We perform a flexible sigmoidoscopy to reduce a sigmoid volvulus and then perform definitive …
… The most common benign cause of colorectal obstruction is volvulus (5 to 15 percent), with sigmoid volvulus the most common etiology of large bowel obstruction in the developing world . Other causes include …
…and may demonstrate findings that indicate the immediate need for urgent decompression (eg, sigmoid volvulus) or surgical intervention (eg, pneumoperitoneum, cecal or midgut volvulus) . Plain radiography …
…cecal volvulus increased by 5.53 percent per year, whereas the incidence of sigmoid volvulus remained stable. Sigmoid volvulus was more common in older adult males >70 years old, African Americans, and …
English Journal
Side-to-Side Anastomosis In Left Hemicolectomy, Why and When: A Single-Center Experience.
Macina S, Imperatore M, Feleppa C, Sucameli F, Talamo G, Falco E, Berti S.
Laparoscopic colectomy represents a safe, effective and well-established procedure for both benign and malignant colic disease. Transanal anastomosis (TA) with a circular stapler is the most commonly performed anastomotic technique in laparoscopic left hemicolectomy (LLH). We report our experience w
Sigmoid volvulus treated with colonoscopic decompression followed by snare-assisted side-hole tube placement- a video vignette.
Hsu CW, Wu CC.
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 2019 May;().
We clearly demonstrate that colonoscopic decompression followed by snare-assisted side-hole tube placement is an effectively temporary treatment for sigmoid volvulus. This article is protected by copyright. All rights reserved.
Colonoscopy-assisted percutaneous sigmoidopexy: a novel, simple, safe, and efficient treatment for inoperable sigmoid volvulus (with videos).
Imakita T, Suzuki Y, Ohdaira H, Urashima M.
Gastrointestinal endoscopy. 2019 May;().
Many patients with sigmoid volvulus are old with co-morbidities making elective surgery prohibitive. Colonoscopic management is often successful but volvulus often recurs. We devised a method of colonoscopy-assisted percutaneous sigmoidopexy as an alternative method to prevent recurrence of sigmoid
消化器内視鏡の進歩：Progress of Digestive Endoscopy 93(1), 136-137, 2018
… The image examination confirmed sigmoidvolvulus. … The inferior mesenteric veins thrombosis might be associated with blood flow disturbance due to sigmoidvolvulus. … The present case is the first reported case of the inferior mesenteric veins thrombosis associated with sigmoidvolvulus. …
Volvulus refers to torsion of a segment of the alimentary tract, which often leads to bowel obstruction. The most common sites of volvulus are the sigmoid colon ... INTRODUCTION Volvulus refers to torsion of a segment of the ...
Sigmoid volvulus is the most common form of volvulus of the gastrointestinal tract; it is responsible for 8% of all intestinal obstructions. Sigmoid volvulus is particularly common in elderly persons.
Sigmoid volvulus occurs in cases of long-standing chronic constipation where patients develop a large, elongated, relatively atonic colon, particularly in the sigmoid. ... Decompression With the patient in the left lateral ...