Colonic Volvulus

Abstract

Volvulus of the bowel refers to a twisting or torsion of the intestine about its mesentery. Volvulus of the colon usually occurs in the sigmoid or cecum, but may involve any segment of colon. In the United States, volvulus represents a rare cause of intestinal obstruction, encompassing less than 5% of large bowel obstructions. However, worldwide it is a much more common form of large bowel obstruction, representing more than 50% of the cases in some countries. With widespread use of flexible endoscopy, many authors have reported successful detorsion and decompression of all forms of colonic volvulus using the colonoscope or flexible sigmoidoscope. Because of high recurrence rates, these endoscopic methods are currently recommended as definitive treatment only for very high-risk individuals who are too ill to undergo surgery, and as a temporizing measure until eventual surgery under more controlled conditions for all other patients.