{
  "schemaVersion": 2,
  "eyebrow": "Emergency General Surgery",
  "title": "Volvulus",
  "summary": "Volvulus requires rapid anatomic classification and ischemia assessment: uncomplicated sigmoid volvulus usually undergoes urgent endoscopic detorsion, whereas peritonitis, perforation, ischemia, cecal volvulus, and midgut volvulus require operative management.",
  "seoDescription": "Point-of-care approach to volvulus: CT diagnosis, ischemia triage, sigmoid endoscopic detorsion, definitive resection, and surgical emergencies.",
  "clinicalQuestion": "How should physicians diagnose, triage, and definitively manage suspected intestinal volvulus?",
  "specialty": "Emergency Medicine and General Surgery",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "volvulus",
    "sigmoid volvulus",
    "cecal volvulus",
    "midgut volvulus",
    "intestinal malrotation",
    "large bowel obstruction",
    "endoscopic detorsion"
  ],
  "keyTakeaways": [
    "Peritonitis, suspected perforation, shock, or clinical concern for bowel ischemia should bypass nonoperative detorsion and prompt urgent operative management. [4][18][20][21]",
    "For uncomplicated sigmoid volvulus, urgent endoscopic detorsion with decompression tube placement is first-line treatment; successful detorsion is a bridge, not definitive therapy. [4][11][14][21]",
    "Offer sigmoid resection after successful decompression, preferably during the index admission, because recurrence without resection is high; reported recurrence after endoscopic detorsion is 43%–86%. [8][21]",
    "Use contrast-enhanced multidetector CT when anatomy or complications are uncertain; a mesenteric whirl, transition point, bowel dilation, and ischemic complications direct operative urgency and distinguish colonic from small-bowel patterns. [1][3][5]",
    "Treat neonatal, pediatric, and adult midgut volvulus from malrotation as a surgical emergency because a narrow mesenteric base can rapidly compromise the small-bowel blood supply. [7][22][23][24]"
  ],
  "sections": [
    {
      "id": "initial-triage",
      "eyebrow": "First Decision",
      "heading": "Identify patients who need immediate laparotomy",
      "intro": "The critical distinction is uncomplicated obstruction versus threatened or nonviable bowel.",
      "paragraphs": [
        "Obtain immediate surgical assessment when examination shows peritoneal irritation or when the patient has septic shock, pneumoperitoneum, suspected perforation, or suspected gangrene/ischemia. These features indicate complicated volvulus and favor operative rather than endoscopic management. Perforation, peritonitis, and septic shock have been reported in approximately 5%–25% of adults with sigmoid volvulus. [18][20][21]",
        "In parallel, establish IV access, resuscitate and reassess hemodynamics, and obtain urgent cross-sectional imaging when it will not delay surgery. Volvulus can progress from closed-loop obstruction to ischemia, perforation, sepsis, and death; the urgency is greatest with small-bowel or midgut involvement because mesenteric vascular compromise may involve extensive bowel. [3][4][7][23]",
        "Do not attempt endoscopic detorsion as definitive treatment in a patient with peritoneal signs. Absence of clinical peritonitis is a useful indicator against gangrene in reported sigmoid-volvulus series, but it does not replace repeated abdominal examination and imaging assessment for ischemic complications. [11][20]"
      ],
      "bullets": [
        "Proceed toward urgent operative management for peritonitis, perforation, shock, or bowel ischemia/gangrene. [18][20][21]",
        "Prioritize urgent surgical management for suspected midgut volvulus at any age. [7][22][24]",
        "Use serial examination during resuscitation because deterioration changes a potentially endoscopic sigmoid-volvulus pathway to an operative pathway. [4][20]"
      ],
      "subsections": [],
      "table": {
        "caption": "Disposition is determined principally by bowel viability and volvulus anatomy. [4][19][21][24]",
        "columns": [
          "Clinical or imaging pattern",
          "Next action",
          "Rationale"
        ],
        "rows": [
          [
            "Sigmoid volvulus without peritoneal irritation or evidence of ischemia",
            "Urgent endoscopic detorsion and colonic decompression; plan definitive sigmoid resection after reduction. [4][11][21]",
            "Endoscopic reduction is first-line in uncomplicated disease, but recurrence after nonresection management is high. [8][21]"
          ],
          [
            "Sigmoid volvulus with peritonitis, perforation, septic shock, or gangrene concern",
            "Urgent operative management; do not rely on nonoperative detorsion. [18][20][21]",
            "These are markers of complicated obstruction and possible nonviable bowel. [4][18]"
          ],
          [
            "Cecal volvulus",
            "Obtain urgent surgical management rather than expecting a sigmoid-style endoscopic pathway. [19][24]",
            "Cecal volvulus commonly requires emergency surgery. [19]"
          ],
          [
            "Midgut volvulus or malrotation with acute obstruction",
            "Emergency surgical management. [7][22][24]",
            "A short mesenteric root and narrow mesenteric base predispose to rapid vascular compromise. [7][23][24]"
          ]
        ]
      }
    },
    {
      "id": "imaging-and-anatomic-branching",
      "eyebrow": "Diagnosis",
      "heading": "Use imaging to localize the twist and assess complications",
      "intro": "Contrast-enhanced CT is most useful when plain radiography does not establish anatomy or complications.",
      "paragraphs": [
        "For suspected intestinal volvulus, multidetector CT with IV contrast is the preferred imaging modality for defining the transition point, twisted mesentery, involved bowel segment, and complications. Multiplanar reconstructions improve recognition because the twist is best seen perpendicular to the axis of rotation. [3]",
        "In sigmoid volvulus, abdominal radiography may show a markedly dilated sigmoid loop with an inverted-U, coffee-bean, or bent-inner-tube configuration; the loop may extend cephalad over the liver, termed the northern exposure sign. CT can show a whirl sign and transition points. These findings support the diagnosis but do not determine bowel viability alone. [1][3]",
        "Search CT at the obstruction point for the whirl sign, defined as spiraled collapsed bowel loops and engorged vessels radiating from the twisted bowel. Its location helps discriminate sigmoid from cecal volvulus, which changes the initial procedural plan. [5]",
        "If plain radiography is equivocal in suspected colonic volvulus, a water-soluble contrast enema may demonstrate the torsion point as a bird-beak or mucosal spiral pattern. Water-soluble contrast avoids the risk of barium impaction and barium peritonitis if perforation is unrecognized. [6]"
      ],
      "bullets": [
        "Sigmoid pattern: pelvic-origin dilated sigmoid loop, coffee-bean or inverted-U appearance, collapsed rectum, and CT whirl/transition points. [1][3]",
        "Small-bowel pattern: proximal stomach, duodenum, and small-bowel dilation with distal bowel collapse may be present on radiography, but radiography is nonspecific; use CT to identify the mesenteric twist. [3]",
        "Malrotation pattern: right-sided or midline low duodenojejunal flexure with a high cecum indicates abnormal rotation and a short mesenteric root that predisposes to midgut volvulus. [24]"
      ],
      "subsections": [],
      "table": {
        "caption": "Imaging patterns that alter the anatomic differential and next intervention. [1][3][5][6][24]",
        "columns": [
          "Suspected branch",
          "Key imaging clues",
          "Management implication"
        ],
        "rows": [
          [
            "Sigmoid volvulus",
            "Coffee-bean or inverted-U dilated sigmoid loop on radiograph; northern exposure sign; CT whirl and transition points. [1][3]",
            "If uncomplicated, proceed to urgent endoscopic detorsion; arrange definitive resection after reduction. [4][21]"
          ],
          [
            "Cecal volvulus",
            "Whirl-sign location can distinguish cecal from sigmoid volvulus; radiographs may show marked colonic distention or bird-beak appearance. [5][24]",
            "Favor emergency surgical management. [19]"
          ],
          [
            "Midgut volvulus from malrotation",
            "Mesenteric whirling on CT; abnormal low/right-sided duodenojejunal flexure and high cecum suggest malrotation. [6][24]",
            "Treat as a surgical emergency because extensive small-bowel ischemia can occur. [7][22][24]"
          ],
          [
            "Equivocal colonic torsion",
            "Water-soluble contrast enema showing bird-beak or mucosal spiral at torsion. [6]",
            "Clarifies obstruction site when plain films are nondiagnostic and perforation is not clinically apparent. [6]"
          ]
        ]
      }
    },
    {
      "id": "sigmoid-volvulus-treatment",
      "eyebrow": "Sigmoid Pathway",
      "heading": "Manage uncomplicated sigmoid volvulus with detorsion followed by definitive resection",
      "intro": "Endoscopic decompression relieves the acute obstruction but does not eliminate recurrence risk.",
      "paragraphs": [
        "For hemodynamically stable sigmoid volvulus without peritoneal irritation, perform urgent flexible endoscopic detorsion/decompression. Endoscopic visualization permits assessment of the twisted segment and decompression; placement of a temporary rectal or colonic decompression tube after successful reduction is used as bridge therapy to surgery. [2][4][11][14]",
        "After successful detorsion, offer sigmoid colectomy and preferably perform it during the index admission. WSES guidance strongly recommends resection after resolution because recurrence remains high without resection, and a reported recurrence range after endoscopic detorsion is 43%–86%. [8][21]",
        "If the patient has concomitant megacolon, perform subtotal colectomy rather than sigmoid colectomy alone because remaining colonic segments are prone to recurrent volvulus. This is a strong recommendation based on low-quality evidence. [21]",
        "For patients in whom established operative procedures are judged prohibitively high risk, percutaneous endoscopic colostomy may be considered to maintain reduction; reserve it for this limited population rather than using it routinely. [21]"
      ],
      "bullets": [
        "Endoscopic detorsion is appropriate only after excluding peritoneal irritation and other evidence of complicated volvulus. [11][20]",
        "Leave decompression support temporarily after successful detorsion when using endoscopic reduction as a bridge to elective or index-admission resection. [4]",
        "Do not discharge a successfully detorsed patient without a definitive operative plan unless surgical risk precludes resection. [8][12][21]"
      ],
      "subsections": [
        {
          "heading": "When endoscopic detorsion should not delay surgery",
          "paragraphs": [
            "Escalate directly to surgery when detorsion is not feasible or when ischemia, perforation, peritonitis, or hemodynamic instability is present. Untreated sigmoid volvulus may lead to ischemia, perforation, sepsis, and death; endoscopic treatment is intended for uncomplicated presentations. [4][18][20][21]"
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Practical sigmoid-volvulus sequence after diagnostic confirmation. [4][8][11][21]",
        "columns": [
          "Step",
          "Action",
          "Decision point"
        ],
        "rows": [
          [
            "1. Exclude complicated disease",
            "Assess for peritoneal signs, shock, perforation, and ischemia; obtain CT when it informs anatomy or complications. [3][18][21]",
            "Any concern for nonviable bowel moves the patient to urgent surgery. [20][21]"
          ],
          [
            "2. Relieve uncomplicated obstruction",
            "Perform urgent endoscopic detorsion and decompression, with temporary decompression tube placement. [4][11][14]",
            "Successful reduction restores patency but is not curative. [8][21]"
          ],
          [
            "3. Prevent recurrence",
            "Offer sigmoid resection, preferably during the index admission. [21]",
            "Reported recurrence after endoscopic detorsion alone is 43%–86%. [8]"
          ],
          [
            "4. Modify for colonic phenotype or operative risk",
            "Use subtotal colectomy for concomitant megacolon; consider percutaneous endoscopic colostomy only when operative options are excessively high risk. [21]",
            "Sigmoid resection alone is inadequate for megacolon-associated volvulus. [21]"
          ]
        ]
      }
    },
    {
      "id": "cecal-and-midgut-volvulus",
      "eyebrow": "Operative Branches",
      "heading": "Recognize cecal and midgut volvulus as different emergencies",
      "intro": "Anatomic location determines whether endoscopic sigmoid-style management is appropriate.",
      "paragraphs": [
        "Cecal volvulus involves the ileum, cecum, and proximal ascending colon twisting around the mesentery or folding upward. In contrast to uncomplicated sigmoid volvulus, cecal volvulus commonly requires emergency surgical intervention; identify the location of the CT whirl and the involved colonic segment before selecting an endoscopic approach. [5][19][24]",
        "Midgut volvulus occurs when small bowel twists around the dorsal mesentery and is strongly associated with intestinal malrotation. Malrotation produces abnormal positioning and a narrow mesenteric base; abnormal peritoneal attachments, including Ladd bands, can further predispose to torsion and obstruction. [3][7][23][24]",
        "In neonates, infants, children, and adults with suspected malrotation-associated midgut volvulus, expedite operative management rather than pursuing prolonged diagnostic observation. In adults, malrotation may first manifest as chronic intermittent postprandial pain, nausea, bloating, vomiting, weight loss, or food avoidance, but acute severe pain with vomiting and rapid hemodynamic decline signals acute obstruction or volvulus. [7][22][23][24]",
        "A Ladd procedure addresses midgut volvulus related to malrotation; in a reported adolescent case with extensive mesenteric ischemia, a damage-control Ladd procedure resulted in resolution of ischemia. The operative priority is timely correction before irreversible small-bowel injury. [7]"
      ],
      "bullets": [
        "Do not extrapolate sigmoid endoscopic-detorsion algorithms to cecal volvulus. [19][24]",
        "Consider adult malrotation when recurrent postprandial obstructive symptoms precede an acute small-bowel volvulus presentation. [23]",
        "Treat bilious vomiting or acute obstructive symptoms in an infant or child with concern for malrotation/midgut volvulus as a surgical emergency. [22][24]"
      ],
      "subsections": [],
      "table": {
        "caption": "Major volvulus branches and their procedural implications. [4][7][19][21][24]",
        "columns": [
          "Branch",
          "Predisposing anatomy",
          "Preferred acute direction"
        ],
        "rows": [
          [
            "Sigmoid volvulus",
            "Twist of a redundant sigmoid colon around its mesenteric attachment. [4][19]",
            "Endoscopic detorsion if uncomplicated; urgent surgery if ischemic or perforated; elective/index-admission resection after successful reduction. [4][21]"
          ],
          [
            "Cecal volvulus",
            "Twisting of ileum, cecum, and proximal ascending colon around mesentery or cephalad cecal folding. [19]",
            "Emergency surgical intervention is often required. [19]"
          ],
          [
            "Midgut volvulus",
            "Small bowel twists around dorsal mesentery, often with malrotation and a short mesenteric root. [3][23][24]",
            "Emergency surgery, including correction of malrotation anatomy when present. [7][22][24]"
          ]
        ]
      }
    },
    {
      "id": "post-reduction-and-recurrence",
      "eyebrow": "Definitive Care",
      "heading": "Plan recurrence prevention before the acute episode ends",
      "intro": "Recurrence prevention is a required part of successful sigmoid-volvulus management.",
      "paragraphs": [
        "After endoscopic reduction of sigmoid volvulus, use the hospitalization to determine candidacy for definitive resection rather than treating decompression as endpoint care. Primary endoscopic detorsion followed by elective surgery during a subsequent hospital admission was associated with the best survival in a 342-patient study, while WSES recommends offering sigmoid resection and preferably performing it during the index admission. [12][21]",
        "Use the extent of colonic disease to choose the definitive operation. Concomitant megacolon favors subtotal colectomy because sigmoid colectomy alone leaves recurrence-prone colon behind; patients at excessive operative risk may be candidates for percutaneous endoscopic colostomy, recognizing that this is a selective salvage strategy. [21]",
        "Monitor closely after detorsion for recurrent obstruction, evolving abdominal tenderness, or systemic deterioration, because these changes may indicate recurrent torsion or previously unrecognized ischemic injury and require repeat surgical evaluation. [4][20]"
      ],
      "bullets": [
        "Document the post-detorsion plan for sigmoid resection before discharge or transfer. [21]",
        "Identify megacolon because it changes the definitive operation from segmental sigmoid resection to subtotal colectomy. [21]",
        "Reserve percutaneous endoscopic colostomy for patients in whom standard operative interventions are too high risk. [21]"
      ],
      "subsections": [],
      "table": {
        "caption": "Definitive strategy after sigmoid-volvulus reduction. [8][12][21]",
        "columns": [
          "Post-reduction finding",
          "Definitive plan",
          "Reason"
        ],
        "rows": [
          [
            "Typical sigmoid volvulus after successful detorsion",
            "Offer sigmoid resection, preferably during the index admission. [21]",
            "Nonresection management carries high recurrence risk. [8][21]"
          ],
          [
            "Concomitant megacolon",
            "Subtotal colectomy. [21]",
            "Sigmoid colectomy alone is insufficient because residual colon can volvulize. [21]"
          ],
          [
            "Prohibitive operative risk",
            "Consider percutaneous endoscopic colostomy. [21]",
            "This approach should generally be reserved for patients unsuitable for established operative interventions. [21]"
          ]
        ]
      }
    }
  ],
  "faq": [],
  "references": [
    {
      "number": 1,
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  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "Diagnosis of sigmoid volvulus using the coffee bean, northern exposure sign, whirl sign and transition point | BMJ Case Reports",
      "detail": "casereports.bmj.com",
      "url": "https://casereports.bmj.com/content/2011/bcr.06.2011.4334",
      "authors": "casereports.bmj.com",
      "host": "casereports.bmj.com",
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      "number": 2,
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      "detail": "journals.lww.com",
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      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Title: Sigmoid Volvulus: Diagnosis and Management of a... : American Journal of Gastroenterology\n# **Sigmoid Volvulus: Diagnosis and Management of a Rare Entity**. In this country, sigmoid volvulus is the cause of an estimated 1.9% of large bowel obstructions, although this incidence is known to be ",
      "score": 0.7309246
    },
    {
      "number": 3,
      "title": "Small and large bowel volvulus: Clues to early recognition and complications - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0720048X09006391",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "# Review Small and large bowel volvulus: Clues to early recognition and complications. Pictorial Essay: Small and Large Bowel Volvulus Clues to Early Recognition and Complications.”. Small and large bowel volvulus are uncommon causes of bowel obstruction with nonspecific clinical manifestations whic",
      "score": 0.6783488
    },
    {
      "number": 4,
      "title": "Endoscopic Decompression, Detorsion, and Reduction of Sigmoid Volvulus - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2212097114000260",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Endoscopic Decompression, Detorsion, and Reduction of Sigmoid Volvulus - ScienceDirect\n## Video Journal and Encyclopedia of GI Endoscopy. Volume 2, Issue 1, April 2014, Pages 20-25. Video Journal and Encyclopedia of GI Endoscopy. # Clinical Case Reports Endoscopic Decompression, Detorsion, an",
      "score": 0.67166495
    },
    {
      "number": 5,
      "title": "Can the location of the CT whirl sign assist in differentiating sigmoid from caecal volvulus? - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0009926010003612",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "### RadioGraphics\n\n### The northern exposure sign: a newly described finding in sigmoid volvulus\n\n### AJR Am J Roentgenol\n\n### Computed tomographic appearance of sigmoid volvulus\n\n### Abdominal Imaging\n\n### Significant plain film findings in sigmoid volvulus\n\n### Clin Radiol\n\n## Cited by (22)\n\n### L",
      "score": 0.6238588
    },
    {
      "number": 6,
      "title": "Intestine Volvulus - an overview | ScienceDirect Topics",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/nursing-and-health-professions/intestine-volvulus",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Midgut volvulus can result in intestinal obstruction and acute bowel ischemia. The condition is not restricted to pediatric patients but represents a particular concern in preverbal infants who cannot communicate symptoms, sometimes leading to catastrophic diagnostic delay. In adults, midgut volvulu",
      "score": 0.529045
    },
    {
      "number": 7,
      "title": "Management of midgut volvulus in an incomplete... : International Journal of Surgery Case Reports",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ijscr/fulltext/9900/management_of_midgut_volvulus_in_an_incomplete.459.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Title: Management of midgut volvulus in an incomplete... : International Journal of Surgery Case Reports\n# Management of midgut volvulus in an incomplete common mesentery in a 17-year-old patient: a case report and literature review. Intestinal malrotation encompasses a spectrum of congenital anomal",
      "score": 0.5106191
    },
    {
      "number": 8,
      "title": "Concurrent sigmoid volvulus and caecal adenocarcinoma in a ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/jscr/article-pdf/doi/10.1093/jscr/rjag761/70884259/rjag761.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "In haemodynamically stable patients, endoscopic detorsion is the preferred initial intervention, though recurrence rates of 43%–86% support",
      "score": 0.6350646
    },
    {
      "number": 9,
      "title": "Sigmoid volvulus part 1: Understanding patient experiences and ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1111/codi.70520",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Patient experience was highly varied and included recurrent episodes requiring endoscopic detorsion and undergoing emergency or elective surgery",
      "score": 0.56258565
    },
    {
      "number": 10,
      "title": "Clinical Factors Associated With Endoscopic Decompression Failure ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.70303",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Sigmoid volvulus requires prompt detorsion via endoscopic or surgical intervention. While endoscopic decompression has a reported success",
      "score": 0.55767727
    },
    {
      "number": 11,
      "title": "Endoscopic Detorsion Results in Sigmoid Volvulus: Single‐Center ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1155/2020/1473580",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Endoscopic detorsion is the first-line recommended treatment modality in sigmoid volvulus patients who have no peritoneal irritation signs",
      "score": 0.5489884
    },
    {
      "number": 12,
      "title": "Management and risk factors for colonic volvulus - Oxford Academic",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bjsopen/article/9/5/zraf113/8263437",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Primary endoscopic detorsion followed by elective surgery during a subsequent hospital admission resulted in best survival. Of the 342 patients",
      "score": 0.5139862
    },
    {
      "number": 13,
      "title": "Endoscopic and rectal tube management of pediatric sigmoid ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/jpr3.12165",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Management of sigmoid volvulus may consist of immediate endoscopic detorsion with colonoscopy and subsequent surgical intervention, if no",
      "score": 0.48630774
    },
    {
      "number": 14,
      "title": "Recurrent sigmoid volvulus relieved by transanal ileus tube ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/gastro/article/doi/10.1093/gastro/goac030/6623497",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Colonoscopic decompression and detorsion is the first-line treatment for SV [2]. Although SV has a better chance of success in conservative",
      "score": 0.38908273
    },
    {
      "number": 15,
      "title": "Acute intrathoracic sigmoid volvulus in major congenital ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/jscr/article/2026/2/rjag093/8499713",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Outside of diaphragmatic anomalies, endoscopic decompression is recommended as first-line treatment in sigmoid volvulus, with success rates near",
      "score": 0.32286802
    },
    {
      "number": 16,
      "title": "Recurrent sigmoid volvulus: Cause of colon perforation, sepsis, and ...",
      "detail": "obgyn.onlinelibrary.wiley.com",
      "url": "https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.14764",
      "authors": "obgyn.onlinelibrary.wiley.com",
      "host": "obgyn.onlinelibrary.wiley.com",
      "snippet": "Sigmoid volvulus is one of the most common reasons for intestinal obstruction. Recurrent sigmoid volvulus occurred in only a few cases.",
      "score": 0.29526088
    },
    {
      "number": 17,
      "title": "Sigmoid volvulus in pregnancy: A rare case report - Pfeiffer",
      "detail": "obgyn.onlinelibrary.wiley.com",
      "url": "https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.15384",
      "authors": "obgyn.onlinelibrary.wiley.com",
      "host": "obgyn.onlinelibrary.wiley.com",
      "snippet": "Colonoscopic findings confirmed a sigmoid colon volvulus without evidence of tissue ischemia or necrosis, which was successfully traversed and",
      "score": 0.24638867
    },
    {
      "number": 18,
      "title": "Sigmoid Volvulus in Children: A Structured Diagnostic and Therapeutic Approach",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12277856",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "## ; in a larger number of cases, the sigmoid loop rotates up to 360° (in 50% of cases) . A literature review revealed the lack of established guidelines for the diagnosis and management of sigmoid volvulus in children. A diagnostic and therapeutic algorithm for the management of sigmoid volvulus wa",
      "score": 0.6612456
    },
    {
      "number": 19,
      "title": "Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11086050",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "Abdominal volvulus manifests in various forms, each with distinct anatomical involvement and clinical presentations. Sigmoid volvulus, the most prevalent form of colonic volvulus, entails a twist in the sigmoid colon [2][4]. Cecal volvulus encompasses a twist of the ileum, cecum, and proximal ascendi",
      "score": 0.6399392
    },
    {
      "number": 20,
      "title": "Recurrent Sigmoid Volvulus in Children—Our Experience and Systematic Review of the Current Literature",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10528811",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "Treatment is dependent on the presence or absence of complications, especially gangrene or an occurred or impending perforation. Since the publication by Bruusgaard in 1947, non-operative treatment (NOT) to accomplish emergency detorsion has been established  in adults and later accordingly in child",
      "score": 0.61695945
    },
    {
      "number": 21,
      "title": "WSES consensus guidelines on sigmoid volvulus management",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10186802",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "15..Ballantyne GH. Review of sigmoid volvulus: clinical patterns and pathogenesis. _Dis Colon Rectum_. 1982. 25:823-830. doi: 10.1007/BF02553326 [DOI] [PubMed] [Google Scholar]\n   16..Shepherd JJ. The epidemiology and clinical presentation of sigmoid volvulus. _Br J Surg_. 1969. 56:353-359. doi: 10.",
      "score": 0.57952
    },
    {
      "number": 22,
      "title": "Midgut Volvulus - StatPearls - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK441962",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Draus JM Jr, Foley DS, Bond SJ. Am Surg. 2007 Jul; 73(7):693-6.\n Review Diagnosis and management of intestinal rotational abnormalities with or without volvulus in the pediatric population.[Semin Pediatr Surg. 2022]\n\n  Review Diagnosis and management of intestinal rotational abnormalities with or wi",
      "score": 0.53094244
    },
    {
      "number": 23,
      "title": "Midgut Malrotation - StatPearls - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK560888",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "7.\n:   Yang X, Wang W, Wang K, Zhao J, Sun L, Jiang S, Wang Y, Feng W, Ding G, Fu T, Li A, Geng L. Identification and treatment of intestinal malrotation with midgut volvulus in childhood: a multicenter retrospective study. Front Pediatr. 2024;12:1390856. [PMC free article: PMC11128588] [PubMed: 388",
      "score": 0.48674685
    },
    {
      "number": 24,
      "title": "The Pediatric Gastrointestinal Tract: What Every Radiologist Needs to Know - Diseases of the Abdomen and Pelvis 2018-2021 - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK543791",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "18.\n:   Andersen JF, Eklof O, Thomasson B. Large bowel volvulus in children. Review of a case material and the literature. Pediatr Radiol. 1981;11(3):129–38. [PubMed: 7322651] [CrossRef]\n\n19.\n:   Atamanalp SS, Yildirgan MI, Basoglu M, Kantarci M, Yilmaz I. Sigmoid colon volvulus in children: review ",
      "score": 0.4703723
    }
  ],
  "publishedAt": "2026-09-16T01:11:02.656833+00:00",
  "updatedAt": "2026-09-16T01:11:02.656833+00:00",
  "readingMinutes": 6,
  "slug": "volvulus"
}