Diagnostic modalities imaging of sigmoid volvulus in adults

Ayu Aditya Willy Wrastuti; Gede Angga Swistrawan Marto

doi:10.18203/2349-3933.ijam20243821

Authors

Ayu Aditya Willy Wrastuti Surya Husadha Ubung Hospital, Denpasar, Bali, Indonesia
Gede Angga Swistrawan Marto Department of Radiology, Surya Husadha Ubung Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20243821

Keywords:

Sigmoid volvulus, Abdominal plain X-ray, Abdominal computerized tomography

Abstract

In adults, large bowel obstruction is predominantly attributed to colon or rectal cancer, diverticular disease, or colonic volvulus. Obstruction from the colonic volvulus results from twisting a redundant segment of the colon on its mesentery. Volvulus predominantly occurs in the sigmoid colon or cecum in over 95% of cases, with the remainder involving either the transverse colon or splenic flexure. The diagnosis of volvulus is established through clinical evaluation and imaging modalities. Abdominal plain x-rays are usually diagnostic with a coffee bean appearance showing a massive distended sigmoid colon, providing diagnostic clarity in 50% to 75% of cases. Nevertheless, the diagnostic efficacy of abdominal computerized tomography (CT) and magnetic resonance imaging (MRI) is typically claimed to exceed 90%. In CT and MRI, the characteristic finding of sigmoid volvulus is the mesenteric whirl sign, resulting from a rotating sigmoid mesentery, together with a dilated sigmoid colon and air-fluid levels in the small intestine. The diagnostic accuracy of CT and MRI was 97.3% and 95.6% respectively.

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References

Vogel JD, Feingold DL, Stewart DB, Turner JS, Boutros M, Chun J, et al. Clinical practice guidelines for colon volvulus and acute colonic pseudo-obstruction. Dis Colon Rectum. 2016;59(7):589–600.

Nahirniak P, Anand S, Cooper W. Volvulus. In: NCBI Bookshelf. India: StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov. Accesssed on 18 August 2024.

Tian BWCA, Vigutto G, Tan E, van Goor H, Bendinelli C, Abu-Zidan F, et al. WSES consensus guidelines on sigmoid volvulus management. World J Emerg Surg. 2023;18(1):34.

Atamanalp SS, Disci E, Peksoz R, Atamanalp RS, Tatar Atamanalp C. Management of sigmoid volvulus: a literature review. Ibnosina J Med Biomed Sci. 2024;16(01):5–9.

Sarfaraz M, Hasan SR, Lateef S. Sigmoid volvulus in young patients: Ą new twist on an old diagnosis. Intractable Rare Dis Res. 2017;6(3):219–23.

Kajihara Y. Sigmoid volvulus: Coffee bean sign, whirl sign. Cleve Clin J Med. 2020;87(2):81–2.

Selais A, Salem A, El-Jabri R. Young adult with acute sigmoid volvulus. Bahrain Med Bull [Internet]. 2019;41(3):171–3.

Saba M, Rosenberg J, Wu G, Hinika G. A case of sigmoid volvulus in an unexpected demographic. Surg Case Reports. 2021;7(1):13.

Kumar HR, Soma M. Sigmoid volvulus: a narrative review and current management. Asian J Med Heal. 2023;21(10):121–7.

Choi SY, Kim KH. Recurrent attacks of sigmoid volvulus in a 16-year-old boy: a case report. 2020;26(1):28–32.

Toh JWT, Collins GP, Ridley LJ, Chan M, Schofield R. A tale of two twists: mesentero‐axial and organo‐axial sigmoid volvulus. J Med Imaging Radiat Oncol. 2023;67(3):252–9.

Nasery MN, Guler E, Houeibib EM. Imaging finding of the sigmoid volvulus, A case report. 2020. Available from: https://www.eurorad.org. Accessed on 12 August 2024.

Atamanalp SS, Peksoz R, Disci E. Sigmoid Volvulus and Ileosigmoid Knotting: An Update. Eurasian J Med. 2023;54(1):91–6.

Alavi K, Thorsen AJ, Fang SH, Burgess PL, Trevisani G, Lightner AL, et al. The American society of colon and rectal surgeons clinical practice guidelines for the evaluation and management of chronic constipation. Dis Colon Rectum. 2024;67(10):1244-57.

SF H. Volvulus of sigmoid colon in 68-year-old male: a case report. Austin J Emerg Crit Care Med. 2017;4(3):3-5.

Atamanalp SS, Disci E. Sigmoid Volvulus: Diagnostic Modalities and Sigmoid Gangrene. Eurasian J Med. 2021;53(2):166-7.

Bettina L, Antunes C. Sigmoid volvulus. in: national library of medicine. Singapore: StatPearls Publishing; 2024. Available at: https://www.ncbi.nlm.nih.gov. Accessed on 21 August 2024.

Wortman JR, Dhyani M, Ali SM, Scholz FJ. Pearls and pitfalls in multimodality imaging of colonic volvulus. Radio Graphics. 2020;40(4):1039-40.

Kiyaka SM, Sikakulya FK, Masereka R, Okedi XF, Anyama P. Sigmoid volvulus in an adolescent female: A case report. Int J Surg Case Rep. 2021;87:106430.

Idzelytė I, Lobinas T, Strakšytė V. The key radiologic features of sigmoid volvulus : a case report with a review of literature. 2020;8(18):48-53.