Sigmoid Volvulus

Published: 03/15/2012

Authors: Chamisa I

This intra-operative image shows a massive gangrenous sigmoid volvulus with signs of impending rupture. Patients who develop sigmoid volvulus in the industrialised world tend to be older, and a third of patients either have mental illness or are institutionalised. Initial treatment involves correction of fluid and electrolyte imbalance followed by endoscopic decompression. Indications for emergency laparotomy include clinical signs and symptoms of colonic ischaemia, failed decompression and clinical features suggestive of colonic ischaemia at colonoscopy.