Medical Science: Updates and Prospects Vol. 8

Colonic volvulus (CV) is a rare but potentially life-threatening condition with unclear etiopathogenesis.  It refers to the medical condition characterised by the twisting of a segment of the colon around its narrow and fixed mesentery, resulting in a closed-loop obstruction due to a redundant loop of the colon.  This chapter aims to review the various etiologies and management strategies of colonic volvulus. Colonic volvulus represents an infrequent aetiology of large bowel obstruction, predominantly observed in elderly patients. Clinically, it manifests as abdominal pain and distension, subsequently leading to absolute constipation. Diagnosis is typically achieved through abdominal X-ray or computed tomography. Sigmoid volvulus is the most prevalent form, followed by cecal and transverse colon volvulus. Ileo-sigmoid knotting is a rare but dangerous form of volvulus, which is associated with a high risk of gangrene of the bowel and subsequent mortality. The management of colonic volvulus is categorised into endoscopic detorsion and surgical intervention, which may involve resection. Early diagnosis and timely intervention are essential to reduce morbidity and mortality associated with this condition.