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Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon. It is a common cause of bowel obstruction [ 1 ] and constipation . It is common in Asia, India (7% of intestinal obstruction ) and especially South India because of the high fibre diet.
Volvulus occurs most frequently in middle-aged and elderly men. [11] Volvulus can also arise as a rare complication in persons with redundant colon, a normal anatomic variation resulting in extra colonic loops. [12] Sigmoid volvulus is the most-common form of volvulus of the gastrointestinal tract.
An ileosigmoid knot or compound volvulus is an uncommon cause of intestinal blockage. [1] The condition arises when ileum loops wrap around the bottom of a redundant sigmoid loop. [ 2 ] In some countries in Africa, Asia, and the Middle East, the ileosigmoid knot is a well-known ailment; this condition is uncommon in the West.
The Hartmann's procedure with a proximal end colostomy or ileostomy is the most common operation carried out by general surgeons for management of malignant obstruction of the distal colon. During this procedure, the lesion is removed, the distal bowel closed intraperitoneally, and the proximal bowel diverted with a stoma .
The sigmoid colon is completely surrounded by peritoneum (and thus is not retroperitoneal), which forms a mesentery (sigmoid mesocolon), which diminishes in length from the center toward the ends of the loop, where it disappears, so that the loop is fixed at its junctions with the iliac colon and rectum, but enjoys a considerable range of movement in its central portion.
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Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischemia or perforation from prolonged distension or ...
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