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Initial Computed Tomography Findings of Long and Distended Colon Are Risk Factors for the Recurrence of Sigmoid Volvulus

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Abstract

Background

Sigmoid volvulus is a common condition in elderly patients with elongated colons. Although endoscopic de-torsion is effective as the primary treatment of sigmoid volvulus, elective surgery is recommended because of the high risk of recurrence and high mortality rate.

Aim

The aim of this study was to determine the risk factors for the recurrence of sigmoid volvulus.

Methods

Clinical records of patients treated at Shimane Prefectural Central Hospital were reviewed retrospectively. Among 41 sigmoid volvulus patients who were successfully treated by endoscopic de-torsion and followed up, 30 were observed over 1 year. Among the 30 patients, eight (26.7%) did not experience recurrence, while 22 (73.3%) did. Initial computed tomography (CT) findings indicating the sigmoid colon extending to the diaphragm or ventral to the liver were defined as “extension findings.” Extension findings and sigmoid diameter were evaluated in relation to sigmoid volvulus recurrence.

Results

Extension findings were significantly more frequent in the recurrent group (77.3%) than in the nonrecurrent group (25.0%) (P = 0.009). Distended sigmoid colon diameter was significantly larger in the recurrent group (11.7 ± 3.8 cm) than in the nonrecurrent group (7.1 ± 1.1 cm) (P = 0.044). Receiver operating characteristic curve analysis demonstrated that the performance threshold was greater than 8.9 cm. Kaplan–Meier analysis showed the significantly high sigmoid volvulus recurrence rate in the patients with extension findings and a distended sigmoid colon greater than 8.9 cm.

Conclusions

CT findings of a long and distended sigmoid colon in initial sigmoid volvulus are risk factors for the recurrence of sigmoid volvulus.

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Acknowledgments

We gratefully acknowledge the work of past and present members of our endoscopic department and Mr. Takayuki Naitani in Shimane Prefectural Central Hospital.

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Authors and Affiliations

  1. Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, Shimane, 693-8555, Japan

    Ryusaku Kusunoki, Hirofumi Fujishiro, Shinsuke Suemitsu, Masatoshi Kataoka, Aya Fujiwara, Kosuke Tsukano, Satoshi Kotani, Satoshi Yamanouchi, Masahito Aimi, Naruaki Kohge & Tomonori Imaoka

  2. Department of Hepatology, Shimane Prefectural Central Hospital, Izumo, Japan

    Tatsuya Miyake

  3. Department of Endoscopy, Shimane Prefectural Central Hospital, Izumo, Japan

    Masaki Tanaka & Youichi Miyaoka

  4. Department of Radiology, Shimane Prefectural Central Hospital, Izumo, Japan

    Kouji Yuasa & Kouji Kodama

  5. Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan

    Shunji Ishihara & Yoshikazu Kinoshita

Authors
  1. Ryusaku Kusunoki
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  2. Hirofumi Fujishiro
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  3. Tatsuya Miyake
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  4. Shinsuke Suemitsu
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  5. Masatoshi Kataoka
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  6. Aya Fujiwara
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  7. Kosuke Tsukano
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  8. Satoshi Kotani
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  9. Satoshi Yamanouchi
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  10. Masahito Aimi
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  11. Masaki Tanaka
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  12. Youichi Miyaoka
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  13. Naruaki Kohge
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  14. Tomonori Imaoka
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  15. Kouji Yuasa
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  16. Kouji Kodama
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  17. Shunji Ishihara
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  18. Yoshikazu Kinoshita
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Corresponding author

Correspondence to Ryusaku Kusunoki.

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Kusunoki, R., Fujishiro, H., Miyake, T. et al. Initial Computed Tomography Findings of Long and Distended Colon Are Risk Factors for the Recurrence of Sigmoid Volvulus. Dig Dis Sci 66, 1162–1167 (2021). https://doi.org/10.1007/s10620-020-06317-z

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  • DOI: https://doi.org/10.1007/s10620-020-06317-z

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