Sigmoid Volvulus and Ileosigmoid Knotting: An Update

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Abdominal Imaging

Background:

• Sigmoid volvulus and ileosigmoid knotting are uncommon causes of intestinal obstruction.
• These conditions predominantly affect adult males and have multifactorial etiologies.
• Clinical presentation typically includes abdominal pain, distention, and constipation.

Purpose of the Study:

• To review the diagnosis and management of sigmoid volvulus and ileosigmoid knotting.
• To highlight the diagnostic modalities and treatment strategies for these conditions.

Main Methods:

• Review of existing literature on sigmoid volvulus and ileosigmoid knotting.
• Discussion of diagnostic tools including radiography, computed tomography, magnetic resonance imaging, and endoscopy.
• Analysis of treatment options: endoscopic decompression versus emergency surgery.

Main Results:

• Computed tomography and magnetic resonance imaging are current gold standards for diagnosis, often supplemented by endoscopy.
• Endoscopic decompression is the primary treatment for sigmoid volvulus without complications.
• Emergency surgery is indicated for sigmoid volvulus with gangrene or peritonitis, and for all cases of ileosigmoid knotting.

Conclusions:

• Prompt diagnosis and appropriate management are crucial for improving outcomes.
• Ileosigmoid knotting and complicated sigmoid volvulus carry a poor prognosis.
• Multidisciplinary approaches involving gastroenterologists and surgeons are essential.