Colonic Volvulus

Colonic volvulus most commonly occurs in the sigmoid colon or the cecum. Colonic volvulus must be in the differential diagnosis of a patient presenting with symptoms of a large bowel obstruction. Radiographic images usually confirm the diagnosis. Patients with peritonitis or shock are taken emergently to the operating room. For stable patients with sigmoid volvulus, initial endoscopic reduction is undertaken with sigmoid resection performed as an elective procedure following resuscitation and bowel preparation. For patients with cecal volvulus or bascule, operative resection is typically offered. Recommendations for colonic anastomosis or diversion follow generally established surgical principles.