Download PDF
CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2024; 16(01): 005-009
DOI: 10.1055/s-0043-1776142
Review Article

Management of Sigmoid Volvulus: A Literature Review

Sabri Selcuk Atamanalp 
1   Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Esra Disci
1   Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Rifat Peksoz
1   Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Refik Selim Atamanalp
2   Department of Medical Pathology, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey
,
Cansu Tatar Atamanalp
3   Department of Pediatrics, Haseki Education and Research Hospital, İstanbul, Turkey
› Author Affiliations Funding and Sponsorship None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Sigmoid volvulus (SV) is a rare form of intestinal obstruction in which the sigmoid colon twists around its own base. Endoscopic detorsion is the primary treatment in uncomplicated patients, while urgent surgery is required in the cases with bowel perforation, peritonitis, and unsuccessful endoscopic detorsion. In surgery, the gangrenous sigmoid colon is managed by resection, whereas sigmoid detorsion alone or with an additional recurrence-reducing procedure is applied in patients with viable bowel. However, the risk of recurrence following endoscopic or operative detorsion alone is as high as 90% with a risk of mortality up to 35%. To prevent or reduce SV recurrence, some selected cases require emergent or elective recurrence-preventive management including sigmoidopexy, mesopexy, mesoplasty, extraperitonealization, sigmoidectomy, and endoscopic percutaneous sigmoidopexy. However, the indications, techniques, and results of the above-mentioned procedures are controversial. In this review, the treatment options of SV and patient selection criteria for recurrence-preventive treatments are discussed.

Keywords

sigmoid volvulus - management - follow-up - recurrence - recurrence prevention

Authors' Contribution

S.S.A. proposed the study, performed the literature searches, and drafted the manuscript. All the authors reviewed the whole document for intellectual content. All the authors approved the final version of the manuscript.


Compliance with Ethical Principles

No ethical approval is required for this type of study (review article).




Publication History

Article published online:
01 November 2023

© 2023. The Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Lai SH, Vogel JD. Diagnosis and management of colonic volvulus. Dis Colon Rectum 2021; 64 (04) 375-378
    CrossrefPubMedGoogle Scholar
  • 2 Atamanalp SS, Peksöz R, Dişçi E. Sigmoid volvulus and ileosigmoid knotting: An update. Eurasian J Med 2022; 54 (Suppl. 01) 91-96
    CrossrefPubMedGoogle Scholar
  • 3 Miller AS, Boyce K, Box B. et al. The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery. Colorectal Dis 2021; 23 (02) 476-547
    CrossrefPubMedGoogle Scholar
  • 4 Atamanalp SS. Sigmoid volvulus: diagnosis in 938 patients over 45.5 years. Tech Coloproctol 2013; 17 (04) 419-424
    CrossrefPubMedGoogle Scholar
  • 5 Tian BWCA, Vigutto G, Tan E. et al. WSES consensus guidelines on sigmoid volvulus management. World J Emerg Surg 2023; 18 (01) 34
    CrossrefPubMedGoogle Scholar
  • 6 Atamanalp SS, Disci E. Sigmoid volvulus: diagnostic modalities and sigmoid gangrene. Eurasian J Med 2021; 53 (02) 166-167
    CrossrefPubMedGoogle Scholar
  • 7 Naveed M, Jamil LH, Fujii-Lau LL. 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 2020; 91 (02) 228-235
    CrossrefPubMedGoogle Scholar
  • 8 Atamanalp SS, Peksoz R. Sigmoid volvulus: treatment options and volvulus recurrence. Emerg Care J 2021; 17 (04) 10294
    CrossrefGoogle Scholar
  • 9 Rajan R, Clark DA. Current management of large bowel obstruction: a narrative review. Ann Laparosc Endosc Surg 2022; 7 (23) 21-45
    Google Scholar
  • 10 Atamanalp SS. Treatment of sigmoid volvulus: a single-center experience of 952 patients over 46.5 years. Tech Coloproctol 2013; 17 (05) 561-569
    CrossrefPubMedGoogle Scholar
  • 11 Pattanaik SM. Emergency management of sigmoid colon volvulus in a volvulus belt population and review of literature. Indian J Surg 2018; 80 (06) 599-605
    CrossrefGoogle Scholar
  • 12 Atamanalp SS, Disci E, Atamanalp CT, Atamanalp RS. Spontaneous detorsion of sigmoid volvulus in a patient with nineteen-volvulus episode history: a rare outcome of an extremely rare clinical entity. Pak J Med Sci 2021; 37 (07) 2029-2031
    CrossrefPubMedGoogle Scholar
  • 13 Alavi K, Poylin V, Davids JS. et al; Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of colonic volvulus and colonic pseudo-obstruction. Dis Colon Rectum 2021; 64 (09) 1046-1057
    CrossrefPubMedGoogle Scholar
  • 14 Atamanalp SS. Endoscopic decompression of sigmoid volvulus: review of 748 patients. J Laparoendosc Adv Surg Tech A 2022; 32 (07) 763-767
    CrossrefPubMedGoogle Scholar
  • 15 Atamanalp SS, Dişçi E, Peksöz R. et al. Recurrence-preventive role of flatus tubes following endoscopic decompression in sigmoid volvulus. Turk J Gastroenterol 2023; 34 (04) 371-377
    CrossrefPubMedGoogle Scholar
  • 16 Bauman ZM, Evans CH. Volvulus. Surg Clin North Am 2018; 98 (05) 973-993
    CrossrefPubMedGoogle Scholar
  • 17 Atamanalp SS. Expert commentary on the diagnosis and management of colonic volvulus. Dis Colon Rectum 2021; 64 (04) 378-379
    CrossrefPubMedGoogle Scholar
  • 18 Kapadia MR. Volvulus of the small bowel and colon. Clin Colon Rectal Surg 2017; 30 (01) 40-45
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Atamanalp SS. Sigmoid volvulus: an update for Atamanalp classification. Pak J Med Sci 2020; 36 (05) 1137-1139
    CrossrefPubMedGoogle Scholar
  • 20 Perrot L, Fohlen A, Alves A, Lubrano J. Management of the colonic volvulus in 2016. J Visc Surg 2016; 153 (03) 183-192
    CrossrefPubMedGoogle Scholar
  • 21 Atamanalp SS, Atamanalp RS. The role of sigmoidoscopy in the diagnosis and treatment of sigmoid volvulus. Pak J Med Sci 2016; 32 (01) 244-248
    PubMedGoogle Scholar
  • 22 Quénéhervé L, Dagouat C, Le Rhun M. et al. Outcomes of first-line endoscopic management for patients with sigmoid volvulus. Dig Liver Dis 2019; 51 (03) 386-390
    CrossrefPubMedGoogle Scholar
  • 23 Johansson N, Rosemar A, Angenete E. Risk of recurrence of sigmoid volvulus: a single-centre cohort study. Colorectal Dis 2018; 20 (06) 529-535
    CrossrefPubMedGoogle Scholar
  • 24 Loria A, Jacobson T, Melucci AD. et al. Sigmoid volvulus: evaluating identification strategies and contemporary multicenter outcomes. Am J Surg 2023; 225 (01) 191-197
    CrossrefPubMedGoogle Scholar
  • 25 Lofgran T, Koury R. A twist on adolescent abdominal pain in the emergency department. Cureus 2022; 14 (07) e27371
    PubMedGoogle Scholar
  • 26 Moro-Valdezate D, Martín-Arévalo J, Pla-Martí V. et al. Sigmoid volvulus: outcomes of treatment and predictors of morbidity and mortality. Langenbecks Arch Surg 2022; 407 (03) 1161-1171
    CrossrefPubMedGoogle Scholar
  • 27 Hardy NP, McEntee PD, McCormick PH, Mehigan BJ, Larkin JO. Sigmoid volvulus: definitive surgery is safe and should be considered in all instances. Ir J Med Sci 2022; 191 (03) 1291-1295
    CrossrefPubMedGoogle Scholar
  • 28 Emna T, Atef M, Sarra S. Management of acute sigmoid volvulus: a Tunisian experience. Asian J Surg 2022; 45 (01) 148-153
    CrossrefPubMedGoogle Scholar
  • 29 Korkut E, Peksoz R, Disci E, Atamanalp SS. Factors affecting recurrence in sigmoid volvulus. Pak J Med Sci 2023; 39 (01) 150-153
    PubMedGoogle Scholar
  • 30 Raahave D. Dolichocolon revisited: an inborn anatomic variant with redundancies causing constipation and volvulus. World J Gastrointest Surg 2018; 10 (02) 6-12
    CrossrefPubMedGoogle Scholar
  • 31 Bayeh AB, Abegaz BA. The role of sigmoid colon anatomic dimensions in the development of sigmoid volvulus, North-Western Ethiopia. PLoS One 2021; 16 (12) e0260708
    CrossrefPubMedGoogle Scholar
  • 32 Atamanalp SS, Atamanalp RS. Sigmoid volvulus: avoiding recurrence. Tech Coloproctol 2019; 23 (04) 405-406
    CrossrefPubMedGoogle Scholar
  • 33 Humbert C, Grillet F, Malakhia A. et al. Stratification of sigmoid volvulus early recurrence risk using a combination of CT features. Diagn Interv Imaging 2022; 103 (02) 79-85
    CrossrefPubMedGoogle Scholar
  • 34 Kusunoki R, Fujishiro H, Miyake T. et al. Initial computed tomography findings of long and distended colon are risk factors for the recurrence of sigmoid volvulus. Dig Dis Sci 2021; 66 (04) 1162-1167
    CrossrefPubMedGoogle Scholar
  • 35 Atamanalp SS, Atamanalp RS. Reply to “Comment on colopexy in sigmoid volvulus recurrence.”. Tech Coloproctol 2019; 23 (09) 935-936
    CrossrefPubMedGoogle Scholar
  • 36 Orban YA, Safwat K, Awad JRI, Asjour H, Yassin MA. Sigmoidopexy versus sigmoidectomy for sigmoid volvulus through left iliac incision in high-risk patients. Egypt J Surg 2023; 41 (01) 135-140
    Google Scholar
  • 37 Atamanalp SS, Atamanalp RS. Reply to “Comment on mesopexy and mesoplasty in sigmoid volvulus recurrence.”. Tech Coloproctol 2019; 23 (12) 1179-1180
    CrossrefPubMedGoogle Scholar
  • 38 Akhtar M, Khan I. Management of viable sigmoid volvulus by mesosigmoidoplasty. Gomal J Med Sci 2009; 7 (01) 7-9
    Google Scholar
  • 39 Bach O, Rudloff U, Post S. Modification of mesosigmoidoplasty for nongangrenous sigmoid volvulus. World J Surg 2003; 27 (12) 1329-1332
    CrossrefPubMedGoogle Scholar
  • 40 Aharoni M, Zager Y, Khalilieh S. et al. Laparoscopic fixation of volvulus by extra-peritonealization: a case series. Tech Coloproctol 2022; 26 (06) 489-493
    CrossrefPubMedGoogle Scholar
  • 41 Gosavi R, Centauri S, Teoh W, Nguyen TC, Narasimhan V. Laparoscopic peritoneal flap sigmoidopexy-a video vignette. Colorectal Dis 2023; 25 (04) 817-818
    CrossrefPubMedGoogle Scholar
  • 42 Ndong A, Patel B. Safety and efficacy of laparoscopic surgery in the management of sigmoid volvulus: a systematic review and meta-analysis. Surg Open Dig Adv 2022; 6: 100052
    Google Scholar
  • 43 Nguyen SH, Tavares K, Chinn A, Russell D, Gillern S, Yheulon C. Is laparoscopy underutilized for sigmoid volvulus?. Surg Laparosc Endosc Percutan Tech 2022; 32 (05) 564-570
    CrossrefPubMedGoogle Scholar
  • 44 Uylas U, Gunes O, Kaplan K. A review of sigmoid volvulus and natural orifice specimen extraction surgery. Ann Laparosc Endosc Surg 2022; 7 (25) 1-5
    Google Scholar
  • 45 Seow-En I, Chang SC, Ke TW, Shen MY, Chen HC, Chen WTL. William Tzu-Liang Chen. Uncomplicated sigmoid volvulus is ideal for laparoscopic sigmoidectomy with transrectal natural orifice specimen extraction. Dis Colon Rectum 2021; 64 (05) e90-e93
    CrossrefPubMedGoogle Scholar
  • 46 Chen MZ, Cartmill J, Gilmore A. Natural orifice specimen extraction for colorectal surgery: early adoption in a Western population. Colorectal Dis 2021; 23 (04) 937-943
    CrossrefPubMedGoogle Scholar
  • 47 Frank L, Moran A, Beaton C. Use of percutaneous endoscopic colostomy (PEC) to treat sigmoid volvulus: a systematic review. Endosc Int Open 2016; 4 (07) E737-E741
    Article in Thieme ConnectPubMedGoogle Scholar
  • 48 Coron E. Should we recommend PEC and when?. Endosc Int Open 2016; 4 (07) E742-E743
    Article in Thieme ConnectPubMedGoogle Scholar
  • 49 Farkas N, Kenny R, Conroy M. et al. A single centre 20-year retrospective cohort study: percutaneous endoscopic colostomy. Colorectal Dis 2022; 24 (11) 1390-1396
    CrossrefPubMedGoogle Scholar
  • 50 Jackson S, Hamed MO, Shabbir J. Management of sigmoid volvulus using percutaneous endoscopic colostomy. Ann R Coll Surg Engl 2020; 102 (09) 654-662
    CrossrefPubMedGoogle Scholar
  • 51 Damkjaer MB, Farooqui W, Ifaoui I, Penninga L. Sigmoid volvulus in children. BMJ Case Rep 2021; 14 (5, S2): 492-495
    CrossrefPubMedGoogle Scholar
  • 52 Lee B, Wu A. Pediatric sigmoid volvulus. Pediatr Emerg Care 2019; 35 (12) e232-e233
    CrossrefPubMedGoogle Scholar
  • 53 Parolini F, Orizio P, Bulotta AL. et al. Endoscopic management of sigmoid volvulus in children. World J Gastrointest Endosc 2016; 8 (12) 439-443
    CrossrefPubMedGoogle Scholar
  • 54 Martin G, Montalva L, Paré S. et al. Robotic-assisted colectomy in children: a comparative study with laparoscopic surgery. J Robot Surg 2023; 17 (05) 2287-2295
    CrossrefPubMedGoogle Scholar
  • 55 Bajaj M, Gillespie C, Dale J. Recurrent sigmoid volvulus in pregnancy. ANZ J Surg 2017; 87 (11) E226-E227
    CrossrefPubMedGoogle Scholar
  • 56 Cortez N, Berzosa M, Muddasani K, Ben-David K. Endoscopic decompression of sigmoid volvulus in pregnancy. J Investig Med High Impact Case Rep 2020; 8: 2324709620975939
    CrossrefPubMedGoogle Scholar
  • 57 Avots-Avotins KV, Waugh DE. Colon volvulus and the geriatric patient. Surg Clin North Am 1982; 62 (02) 249-260
    CrossrefPubMedGoogle Scholar
  • 58 Dolejs SC, Guzman MJ, Fajardo AD, Holcomb BK, Robb BW, Waters JA. Contemporary management of sigmoid volvulus. J Gastrointest Surg 2018; 22 (08) 1404-1411
    CrossrefPubMedGoogle Scholar
  • 59 Rajsiddharth B, Patlolla SR, Reddy BS, Sriramoju S, Palley BK, Maripeddi K. A clinical study of sigmoid volvulus. Int J Sci Stud 2016; 3 (10) 158-162
    Google Scholar
  • 60 Bruzzi M, Lefèvre JH, Desaint B. et al. Management of acute sigmoid volvulus: short- and long-term results. Colorectal Dis 2015; 17 (10) 922-928
    CrossrefPubMedGoogle Scholar