Management of Colonic Volvulus

In the United States, colonic volvulus most frequently involves the sigmoid colon (50–70%), followed by the cecum (20%), and patients present with increasing abdominal pain and distention that can evolve over a short period of time. In the absence of bowel ischemia or perforation, sigmoid volvulus can be initially managed with urgent endoscopic decompression, followed by elective sigmoid resection during the same hospital admission. Success at endoscopic decompression of cecal volvulus is lower than for sigmoid volvulus, and therefore cecal volvulus should be managed with a right colectomy.