Value of multidetector-row CT in the management of sigmoid volvulus

Purpose. To determine the value of multidetector-row CT (MDCT) in the management of sigmoid volvulus. Materials and methods. Twenty-three MDCT examinations showing sigmoid volvulus were retrospectively evaluated and analyzed based on the type of volvulus (mesentericoaxial versus organoaxial), degree of rotation (1800 or 360), maximum diameter of the volvulized sigmoid loop and presence or absence of the northern exposure sign, signs of bowel wall ischemia, and ascitis. A statistical analysis was performed to determine the correlation between patients characteristics, CT Findings, type of management, and histological findings when available. Results. In our study, organoaxial volvulus occurred in older patients (p = 0.047), had a higher risk of recurrence (p = 0.015) and more frequently required urgent surgical management than mesentericoaxial volvulus. A higher degree of rotation was associated with a more distended volvulized sigmoid colon (p = 0.033) and more frequently required surgery. Conclusion. In addition to detection of volvulus and signs of bowel wall ischemic, MDCT can characterize the type of volvulus and degree of rotation, findings that may assist in determining the severity of the process and direct towards optimal management, endoscopic or surgical.