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Gastrointestinal
Diagnosis
Colon
Degenerative
Sigmoid Volvulus
Sigmoid Volvulus
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Torsion or twisting of sigmoid colon around its mesenteric axis

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Lieske B et al: Sigmoid volvulus. StatPearls, 2021
                                          2. Atamanalp SS: Sigmoid volvulus: an update for Atamanalp classification. Pak J Med Sci. 36(5):1137-9, 2020
                                          3. Kusunoki R et al: Initial computed tomography findings of long and distended colon are risk factors for the recurrence of sigmoid volvulus. Dig Dis Sci. 66(4):1162-7, 2020
                                          4. Naveed M et al: American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus. Gastrointest Endosc. 91(2):228-35, 2020
                                          5. Stavride E et al: Coffee bean sign: its meaning and importance. Clin Case Rep. 8(10):2086-7, 2020
                                          6. Verheyden C et al: Large-bowel obstruction: CT findings, pitfalls, tips and tricks. Eur J Radiol. 130:109155, 2020
                                          7. Atamanalp SS et al: Sigmoid volvulus: comorbidity with sigmoid gangrene. Pak J Med Sci. 35(1):288-90, 2019
                                          8. Baiu I et al: Sigmoid volvulus. JAMA. 321(24):2478, 2019
                                          9. Sahu KK et al: Omega sign: radiological appearance of sigmoid volvulus. J Med Imaging Radiat Oncol. 63(1):82-3, 2019
                                          10. Bauman ZM et al: Volvulus. Surg Clin North Am. 98(5):973-93, 2018
                                          11. Dolejs SC et al: Contemporary management of sigmoid volvulus. J Gastrointest Surg. 22(8):1404-11, 2018
                                          12. Maddah G et al: Management of sigmoid volvulus: options and prognosis. J Coll Physicians Surg Pak. 24(1):13-7, 2014
                                          13. Selçuk Atamanalp S: Treatment for ileosigmoid knotting: a single-center experience of 74 patients. Tech Coloproctol. 18(3):233-7, 2014
                                          14. Meyer F et al: Unusual "twister"-like appearance of a sigmoid volvulus on computed tomography. Endoscopy. 39 Suppl 1:E295, 2007
                                          15. Tiah L et al: Sigmoid volvulus: diagnostic twists and turns. Eur J Emerg Med. 13(2):84-7, 2006
                                          16. Agaoglu N et al: Surgical treatment of the sigmoid volvulus. Acta Chir Belg. 105(4):365-8, 2005
                                          17. Chandrasekaran TV et al: Minimally invasive stapled surgical approach to the management of sigmoid volvulus. Ann R Coll Surg Engl. 87(5):381-2, 2005
                                          18. Matsumoto S et al: Computed tomographic imaging of abdominal volvulus: pictorial essay. Can Assoc Radiol J. 55(5):297-303, 2004
                                          19. Chiu HH et al: Recurrent sigmoid volvulus. Gastrointest Endosc. 56(3):419-20, 2002
                                          20. Kuzu MA et al: Emergent resection for acute sigmoid volvulus: results of 106 consecutive cases. Dis Colon Rectum. 45(8):1085-90, 2002
                                          21. Chirdan LB et al: Sigmoid volvulus and ileosigmoid knotting in children. Pediatr Surg Int. 17(8):636-7, 2001
                                          22. Moore CJ et al: CT of cecal volvulus: unraveling the image. AJR Am J Roentgenol. 177(1):95-8, 2001
                                          23. Daniels IR et al: Recurrent sigmoid volvulus treated by percutaneous endoscopic colostomy. Br J Surg. 87(10):1419, 2000
                                          24. Dulger M et al: Management of sigmoid colon volvulus. Hepatogastroenterology. 47(35):1280-3, 2000
                                          25. Lee SH et al: The ileosigmoid knot: CT findings. AJR Am J Roentgenol. 174(3):685-7, 2000
                                          26. Madiba TE et al: The management of sigmoid volvulus. J R Coll Surg Edinb. 45(2):74-80, 2000
                                          27. Chung YF et al: Minimizing recurrence after sigmoid volvulus. Br J Surg. 86(2):231-3, 1999
                                          28. Javors BR et al: The northern exposure sign: a newly described finding in sigmoid volvulus. AJR Am J Roentgenol. 173(3):571-4, 1999
                                          29. Choi D et al: Endoscopic sigmoidopexy: a safer way to treat sigmoid volvulus? J R Coll Surg Edinb. 43(1):64, 1998
                                          30. Catalano O: Computed tomographic appearance of sigmoid volvulus. Abdom Imaging. 21(4):314-7, 1996
                                          31. Frizelle FA et al: Colonic volvulus. Adv Surg. 29:131-9, 1996
                                          32. Forde KA: Therapeutic colonoscopy. World J Surg. 16(6):1048-53, 1992
                                          33. Gibney EJ: Volvulus of the sigmoid colon. Surg Gynecol Obstet. 173(3):243-55, 1991
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Torsion or twisting of sigmoid colon around its mesenteric axis

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic Findings

                                                          • CT Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Lieske B et al: Sigmoid volvulus. StatPearls, 2021
                                                                                  2. Atamanalp SS: Sigmoid volvulus: an update for Atamanalp classification. Pak J Med Sci. 36(5):1137-9, 2020
                                                                                  3. Kusunoki R et al: Initial computed tomography findings of long and distended colon are risk factors for the recurrence of sigmoid volvulus. Dig Dis Sci. 66(4):1162-7, 2020
                                                                                  4. Naveed M et al: American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus. Gastrointest Endosc. 91(2):228-35, 2020
                                                                                  5. Stavride E et al: Coffee bean sign: its meaning and importance. Clin Case Rep. 8(10):2086-7, 2020
                                                                                  6. Verheyden C et al: Large-bowel obstruction: CT findings, pitfalls, tips and tricks. Eur J Radiol. 130:109155, 2020
                                                                                  7. Atamanalp SS et al: Sigmoid volvulus: comorbidity with sigmoid gangrene. Pak J Med Sci. 35(1):288-90, 2019
                                                                                  8. Baiu I et al: Sigmoid volvulus. JAMA. 321(24):2478, 2019
                                                                                  9. Sahu KK et al: Omega sign: radiological appearance of sigmoid volvulus. J Med Imaging Radiat Oncol. 63(1):82-3, 2019
                                                                                  10. Bauman ZM et al: Volvulus. Surg Clin North Am. 98(5):973-93, 2018
                                                                                  11. Dolejs SC et al: Contemporary management of sigmoid volvulus. J Gastrointest Surg. 22(8):1404-11, 2018
                                                                                  12. Maddah G et al: Management of sigmoid volvulus: options and prognosis. J Coll Physicians Surg Pak. 24(1):13-7, 2014
                                                                                  13. Selçuk Atamanalp S: Treatment for ileosigmoid knotting: a single-center experience of 74 patients. Tech Coloproctol. 18(3):233-7, 2014
                                                                                  14. Meyer F et al: Unusual "twister"-like appearance of a sigmoid volvulus on computed tomography. Endoscopy. 39 Suppl 1:E295, 2007
                                                                                  15. Tiah L et al: Sigmoid volvulus: diagnostic twists and turns. Eur J Emerg Med. 13(2):84-7, 2006
                                                                                  16. Agaoglu N et al: Surgical treatment of the sigmoid volvulus. Acta Chir Belg. 105(4):365-8, 2005
                                                                                  17. Chandrasekaran TV et al: Minimally invasive stapled surgical approach to the management of sigmoid volvulus. Ann R Coll Surg Engl. 87(5):381-2, 2005
                                                                                  18. Matsumoto S et al: Computed tomographic imaging of abdominal volvulus: pictorial essay. Can Assoc Radiol J. 55(5):297-303, 2004
                                                                                  19. Chiu HH et al: Recurrent sigmoid volvulus. Gastrointest Endosc. 56(3):419-20, 2002
                                                                                  20. Kuzu MA et al: Emergent resection for acute sigmoid volvulus: results of 106 consecutive cases. Dis Colon Rectum. 45(8):1085-90, 2002
                                                                                  21. Chirdan LB et al: Sigmoid volvulus and ileosigmoid knotting in children. Pediatr Surg Int. 17(8):636-7, 2001
                                                                                  22. Moore CJ et al: CT of cecal volvulus: unraveling the image. AJR Am J Roentgenol. 177(1):95-8, 2001
                                                                                  23. Daniels IR et al: Recurrent sigmoid volvulus treated by percutaneous endoscopic colostomy. Br J Surg. 87(10):1419, 2000
                                                                                  24. Dulger M et al: Management of sigmoid colon volvulus. Hepatogastroenterology. 47(35):1280-3, 2000
                                                                                  25. Lee SH et al: The ileosigmoid knot: CT findings. AJR Am J Roentgenol. 174(3):685-7, 2000
                                                                                  26. Madiba TE et al: The management of sigmoid volvulus. J R Coll Surg Edinb. 45(2):74-80, 2000
                                                                                  27. Chung YF et al: Minimizing recurrence after sigmoid volvulus. Br J Surg. 86(2):231-3, 1999
                                                                                  28. Javors BR et al: The northern exposure sign: a newly described finding in sigmoid volvulus. AJR Am J Roentgenol. 173(3):571-4, 1999
                                                                                  29. Choi D et al: Endoscopic sigmoidopexy: a safer way to treat sigmoid volvulus? J R Coll Surg Edinb. 43(1):64, 1998
                                                                                  30. Catalano O: Computed tomographic appearance of sigmoid volvulus. Abdom Imaging. 21(4):314-7, 1996
                                                                                  31. Frizelle FA et al: Colonic volvulus. Adv Surg. 29:131-9, 1996
                                                                                  32. Forde KA: Therapeutic colonoscopy. World J Surg. 16(6):1048-53, 1992
                                                                                  33. Gibney EJ: Volvulus of the sigmoid colon. Surg Gynecol Obstet. 173(3):243-55, 1991