Journal of Gastrointestinal Surgery

, Volume 22, Issue 8, pp 1404–1411 | Cite as

Contemporary Management of Sigmoid Volvulus

  • Scott C. Dolejs
  • Michael J. Guzman
  • Alyssa D. Fajardo
  • Bryan K. Holcomb
  • Bruce W. Robb
  • Joshua A. Waters
Original Article



Sigmoid volvulus is an uncommon cause of bowel obstruction that is historically associated with high morbidity and mortality. The objective of this study was to evaluate contemporary management of sigmoid volvulus and the safety of primary anastomosis in patients with sigmoid volvulus.


The National Surgical Quality Improvement Project from 2012 to 2015 was queried for patients with colonic volvulus who underwent left-sided colonic resection. A propensity score-matched analysis was performed to compare patients with sigmoid volvulus undergoing colectomy with primary anastomosis without proximal diversion to colectomy with end colostomy.


Two thousand five hundred thirty-eight patients with sigmoid volvulus were included for analysis. Patients had a median age of 68 years (interquartile range, 55–80) and 79% were fully independent preoperatively. Fifty-one percent of operations were performed emergently. One thousand eight hundred thirteen (71%) patients underwent colectomy with anastomosis, 240 (10%) colectomy with anastomosis and proximal diversion, and 485 (19%) colectomy with end colostomy. Overall, 30-day mortality and morbidity were 5 and 40%, respectively. After propensity score matching, mortality, overall morbidity, and serious morbidity were similar between groups.


Sigmoid volvulus occurs in elderly and debilitated patients with significant morbidity, mortality, and lifestyle implications. In selected patients, anastomosis without proximal diversion in patients with sigmoid volvulus results in similar outcomes to colectomy with end colostomy.


Sigmoid volvulus Intestinal volvulus Colectomy Colostomy 


Author Contribution

Drs. Dolejs, Guzman, Fajardo, Holcomb, Robb, and Waters made substantial contributions to the conception of the work, revision of the work for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work. Drs. Dolejs and Waters made substantial contributions to the acquisition, analysis, and interpretation of data, and drafted the work.

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Supplementary material

11605_2018_3747_MOESM1_ESM.docx (14 kb)
ESM 1 (DOCX 14 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Scott C. Dolejs
    • 1
  • Michael J. Guzman
    • 1
  • Alyssa D. Fajardo
    • 1
  • Bryan K. Holcomb
    • 1
  • Bruce W. Robb
    • 1
  • Joshua A. Waters
    • 1
  1. 1.Department of SurgeryIndiana University School of MedicineIndianapolisUSA

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