Sigmoid Volvulus Showing "a Whirl Sign" on CT

Hirao, Kentaro; Kikawada, Masayuki; Hanyu, Haruo; Iwamoto, Toshihiko

doi:10.2169/internalmedicine.45.1643

Cited by 20 publications

(11 citation statements)

References 3 publications

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“…CT findings of sigmoid volvulus include "Whirl sign", which represents tension on the twisted mesocolon by the afferent and efferent limbs of the dilated colon. (8) Sonography might occasionally be useful in assessing large bowel obstruction. Barium enema, rectal tubes, rigid and flexible sigmoidoscopy as therapeutic methods have been adopted by clinicians.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Sigmoid Volvulus in Acute Intestinal Obstruction Cases : 3 Years E Xperience

Rambabu¹,

Prasad²,

Reddy³

et al. 2015

jebmh

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Sigmoid volvulus is abnormal rotation of sigmoid colon along it's mesenteric axis which may results in effects ranging from partial to complete obstruction of bowel to vascular compromise, culminating in gangrene of bowel. Sigmoid volvulus is responsible for about 4 -24% of all acute intestinal obstruction. Retrospectively for last 3 years all cases of acute intestinal obstruction admitted to surgery were reviewed and study of sigmoid volvulus cases done. We analysed 247 cases of acute intestinal obstruction retrospectively over a period of 3 years. 50 cases are due to sigmoid volvulus. Most of cases are around 41-60 years. Most of cases present with pain abdomen, abdominal distention, constipation. Diagnosis is made by plain x-ray abdomen. Most cases treated with Derotation, resection and anastomosis. Out of 50 cases 6 deaths occurred.

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Section: Discussionmentioning

confidence: 99%

Clinical Study of Sigmoid Volvulus in Acute Intestinal Obstruction Cases : 3 Years E Xperience

Rambabu¹,

Prasad²,

Reddy³

et al. 2015

jebmh

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“…6,7 Several radiologic diagnostic signs are described, such as omega or horseshoe sign, bird's beak sign, Y sign, northern exposure sign, coffee bean sign, bent inner tube or ace of spades sign, left pelvic overlap or left flank overlap sign, liver overlap sign, the whirl sign, and empty left iliac fossa sign. 7–9 …”

Section: Discussionmentioning

confidence: 99%

Delayed Presentation of Sigmoid Volvulus in a Young Woman

Weingrow¹,

McCague²,

Shah³

et al. 2012

WestJEM

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Volvulus is an unusual condition in Western countries, generally isolated to elderly patients with multiple comorbidities. This report describes an unusual case of a very large gangrenous sigmoid volvulus in a young, otherwise healthy 25-year-old female. A review of the diagnosis and management is subsequently described. Without a consideration of the atypical demographics for sigmoid volvulus, the case illustrates the potential morbidity due to a delayed diagnosis. Early identification and management are crucial in treating sigmoid volvulus before the appearance of gangrene and necrosis, thereby avoiding further complications and associated mortality.

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“…Furthermore a redundant transverse colon or an obstructed small bowel loop may mimic a sigmoid volvulus [17,18]. Conversely CT scan allows to achieve a diagnosis even in the indeterminate cases [19-21] being particularly useful in the patients affected by intestinal subocclusion with ambiguous and insidious clinical onset and progression, and allowing an earlier diagnosis with a lower mortality.…”

Section: Discussionmentioning

confidence: 99%

The sigmoid volvulus: surgical timing and mortality for different clinical types

et al. 2010

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BackgroundIn western countries intestinal obstruction caused by sigmoid volvulus is rare and its mortality remains significant in patients with late diagnosis. The aim of this work is to assess what is the correct surgical timing and how the prognosis changes for the different clinical types.MethodsWe realized a retrospective clinical study including all the patients treated for sigmoid volvulus in the Department of General Surgery, St Maria Hospital, Terni, from January 1996 till January 2009. We selected 23 patients and divided them in 2 groups on the basis of the clinical onset: patients with clear clinical signs of obstruction and patients with subocclusive symptoms. We focused on 30-day postoperative mortality in relation to the surgical timing and procedure performed for each group.ResultsIn the obstruction group mortality rate was 44% and it concerned only the patients who had clinical signs and symptoms of peritonitis and that were treated with a sigmoid resection (57%). Conversely none of the patients treated with intestinal derotation and colopexy died. In the subocclusive group mortality was 35% and it increased up to 50% in those patients with a late diagnosis who underwent a sigmoid resection.ConclusionsThe mortality of patients affected by sigmoid volvulus is related to the disease stage, prompt surgical timing, functional status of the patient and his collaboration with the clinicians in the pre-operative decision making process. Mortality is higher in both obstructed patients with generalized peritonitis and patients affected by subocclusion with late diagnosis and surgical treatment; in both scenarios a Hartmann's procedure is the proper operation to be considered.

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Sigmoid Volvulus Showing "a Whirl Sign" on CT

Cited by 20 publications

References 3 publications

Clinical Study of Sigmoid Volvulus in Acute Intestinal Obstruction Cases : 3 Years E Xperience

Clinical Study of Sigmoid Volvulus in Acute Intestinal Obstruction Cases : 3 Years E Xperience

Delayed Presentation of Sigmoid Volvulus in a Young Woman

The sigmoid volvulus: surgical timing and mortality for different clinical types

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