Sigmoid Volvulus
- Counterclockwise twisting
- The sigmoid colon becomes overloaded with faeces, causing it to sink downwards causing a twist or torsion
Caecal Volvulus
- Clockwise twisting (Caecal – Clockwise)
Risk Factors
- Psychiatric disorders
- Neurological disorders
- Nursing home residents
- Chronic constipation
- Pelvic masses (including pregnancy)
- Adhesions
Complications
- Obstruction
- Ischaemia
- Perforation
Diagnosis
- Presents as intestinal obstruction
- Abdominal xray – coffee bean sign (dilated, twisted sigmoid colon that looks like a giant coffee bean)
- CT scan to confirm diagnosis and identify other pathology
Treatment
- Endoscopic decompression (for sigmoid volvulus with no peritonitis only)
- Laparotomy
- Hartmann’s procedure (sigmoid)
- right hemicolectomy (caecal)