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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The patient with sigmoid volvulus is generally elderly with a long history of constipation and use of laxatives. Note also that this condition has a higher incidence in long stay patients in mental hospitals who have a prolonged history of tranquiliser usage.

Clinical features include:

  • marked abdominal distension
  • sudden onset of colicky pain
  • absolute constipation and no passage flatus for at least 24 hours
  • may be history of previous episodes - colonic twists may spontaneously untwist
  • on examination:
    • abdomen is distended and tympanic
    • left ilac fossa tenderness
    • rectal examination reveals a capacious, empty rectum

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