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The role of the anatomy of the sigmoid colon in developing sigmoid volvulus: a cross-sectional study

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Abstract

Purpose

The aim of this study was to determine the length of the sigmoid colon and sigmoid mesocolon in living subjects and fresh cadavers.

Methods

The subjects for the study were consecutive 50 living subjects undergoing abdominal surgeries via midline incision and 50 fresh cadavers undergoing a medicolegal postmortem at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.

Results

The study showed that the mean length of the sigmoid colon in living subjects was 48.9 ± 1.3 cm (range 30.5–65 cm) while the mean length of the sigmoid colon in cadaver subjects was 50.1 ± 1.6 cm (range 34.5–67.8 cm) and this was not statistically significantly different. Two patterns of the shape of the sigmoid loop were identified: dolichomesocolic and brachymesocolic pattern. In about 80 % of subjects in both groups, dolichomesocolic-type was seen. The gender analysis showed that males had statistically significant longer sigmoid colon (P = 0.040). The dimension of sigmoid colon significantly increased with age of the patients in cadaver subjects and in both sexes (P = 0.001).

Conclusions

The study concluded that the lengths of sigmoid colon are not different in living and cadaver subjects but are relatively longer than measurement from western countries. The lengths of sigmoid colon and mesocolon also increases with age and this may possibly be the anatomical basis for the frequent occurrence of sigmoid volvulus and failed colonoscopy among the older population in our environment.

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References

  1. Akhator A, Umukoro D (2007) Sigmoid volvulus in mid western Nigeria. Niger J Surg Sci 17:59–62

    Google Scholar 

  2. Akinkuotu AA, Samuel JC, Msiska N, Mvula C, Charles AG (2011) The role of the anatomy of the sigmoid colon in developing sigmoid volvulus: a case–control study. Clin Anat 24(5):634–637

    Article  PubMed  Google Scholar 

  3. Bassey DE (1993) Radiological observations in the colon of Nigerians with chronic enema abuse. East Afr Med J 70:452–454

    PubMed  CAS  Google Scholar 

  4. Bhatnagar BNS, Sharma CLN, Gupta SN, Mathur MM, Reddy DCl (2004) Study on the anatomical dimensions of the human sigmoid colon. Clin Anat 17:236–243

    Article  PubMed  CAS  Google Scholar 

  5. Brown JL, Khan N, Moore LA (2010) Large intestine. In: Borley NR, Standring S (eds) Gray’s anatomy: the anatomical basis of clinical practice, 14th edn. Churchill Livingstone, Edinburgh, pp 1147–1148

    Google Scholar 

  6. Bruusgaard C (1947) Volvulus of the sigmoid colon and its treatment. Surgery 22:466–478

    PubMed  CAS  Google Scholar 

  7. Burkitt D (1981) No relation of sigmoid volvulus to fiber content of African diet. N Engl J Med 304:914

    PubMed  CAS  Google Scholar 

  8. El Masri SH (1987) Volvulus. In: Adeloye A (ed) Davey’s companion of surgery in Africa. Churchill Livingstone, Edinburgh, pp 335–348

    Google Scholar 

  9. Grossmann EM, Longo WE, Stratton MD, Virgo KS, Johnson FE (2000) Sigmoid volvulus in Department of Veterans Affairs Medical Centers. Dis Colon Rectum 43:414–418

    Article  PubMed  CAS  Google Scholar 

  10. Hanson ME, Pickhardt PJ, Kim DH, Pfau PR (2007) Anatomic factors predictive of incomplete colonoscopy based on findings at CT colonography. Am J Roentgenol 189:774–779

    Article  Google Scholar 

  11. Heis HA, Bani-Hani KE, Rabadi DK, Elheis MA, Bani-Hani BK, Mazahreh TS, Bataineh ZA, Al-Zoubi NA, Obeidallah MS (2008) Sigmoid volvulus in the Middle East. World J Surg 32:459–464

    Article  PubMed  Google Scholar 

  12. Jit I, Grewal SS (1975) Length of small and large intestines in North Indian subjects. J Anat Soc India 24:89–100

    Google Scholar 

  13. Kohn GJ, Rosnequist CJ, Lawson MJ (1992) Diverticular disease and sigmoid colon length in southeast Asians and Caucasians. Med Sci Res 20:407–408

    Google Scholar 

  14. Lal SK, Morgenstern R, Vinjirayer EP, Matin A (2006) Sigmoid volvulus an update. Gastrointest Endosc Clin N Am 16:175–187

    Article  PubMed  Google Scholar 

  15. Madiba TE, Haffajee MR (2010) Anatomical variations in the level of origin of the sigmoid colon from the descending colon and the attachment of the sigmoid mesocolon. Clin Anat 23:179–185

    PubMed  CAS  Google Scholar 

  16. Madiba TE, Haffajee MR (2010) Sigmoid colon morphology in the population groups of Durban, South Africa, with special reference to sigmoid volvulus. Clin Anat 24:441–453

    Article  Google Scholar 

  17. Madiba TE, Haffajee MR, Sikhosana MH (2008) Radiological anatomy of the sigmoid colon. Surg Radiol Anat 30:409–415

    Article  PubMed  CAS  Google Scholar 

  18. Manzini VT, Madiba TE (2006) Sigmoid volvulus in KwaZulu-Natal Teaching Hospitals: preliminary results. S Afr Med J 96:732

    Google Scholar 

  19. Moore KL, Dalley AF (1999) Abdomen. In: Moore KL, Dalley AF (eds) Clinically oriented anatomy. Lippincott, Philadelphia, pp 174–330

  20. Nuhu A, Jah A (2010) Acute sigmoid volvulus in a West African population. Ann Afr Med 9(2):86–90

    Article  PubMed  Google Scholar 

  21. Raveenthiran V, Madiba TE, Atamanalp SS, De U (2010) Volvulus of the sigmoid colon. Colorectal Dis 12(7):e1–e17

    PubMed  CAS  Google Scholar 

  22. Sadahiro S, Ohmura T, Yamada Y, Saito T, Taki Y (1992) Analysis of length and surface area of each segment of the large intestine according to age sex and physique. Surg Radiol Anat 14:251–257

    Article  PubMed  CAS  Google Scholar 

  23. Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, Williams CB (1996) Why is colonoscopy more difficult in women? Gastrointest Endosc 43:124–126

    Article  PubMed  CAS  Google Scholar 

  24. Saunders BP, Masaki T, Swada T, Halligan S, Phillips RK, Muto T, Williams CB (1995) A preoperative comparison of Western and Oriental colonic anatomy and mesenteric attachments. Int J Colorectal Dis 10:216–221

    Article  PubMed  CAS  Google Scholar 

  25. Schembre DB, Ross AS, Gluck MN, Brandabur JJ, McCormick SE, Lin OS (2011) Spiral overtube-assisted colonoscopy after incomplete colonoscopy in the redundant colon. Gastrointest Endosc 73:515–519

    Article  PubMed  Google Scholar 

  26. Shah HA, Paszat LF, Saskin R, Stukel TA, Rabeneck L (2007) Factors associated with incomplete colonoscopy: a population-based study. Gastroenterology 132:2297–2303

    Article  PubMed  Google Scholar 

  27. Shepherd JJ (1969) The epidemiology and clinical presentation of sigmoid volvulus. Br J Surg 56:353–359

    Article  PubMed  CAS  Google Scholar 

  28. Tegegne A (1995) Cultural bowel patterns and sex difference in sigmoid volvulus morbidity in an Ethiopian hospital. Trop Geogr Med 47:212–215

    PubMed  CAS  Google Scholar 

  29. Williams PL, Bannister LH, Berry MM et al (1995) Gray’s anatomy, 38th edn. Churchill Livingstone, Edinburgh, pp 1777–1778

  30. Yamazaki S, Yamazaki K, Miyazaki T et al (1994) An analysis on the length of the large intestine and its internal diameter amongst the Japanese. Japan Soc Coloproctol 47:31–39

    Article  Google Scholar 

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Correspondence to Olusegun Isaac Alatise.

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Alatise, O.I., Ojo, O., Nwoha, P. et al. The role of the anatomy of the sigmoid colon in developing sigmoid volvulus: a cross-sectional study. Surg Radiol Anat 35, 249–257 (2013). https://doi.org/10.1007/s00276-012-1037-5

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  • DOI: https://doi.org/10.1007/s00276-012-1037-5

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