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Peer-reviewedCC BYCureus

Update on the Management of Acute Sigmoid Volvulus: Endoscopic Decompression and Definitive Surgical Treatment.

  • Constantinos Avgoustou1
  • Christina Avgoustou2
  • Konstantinos Skevis3
  • Dimitrios Jannusis4
4 affiliations
  1. 1Department of Surgery, General Hospital of Nea Ionia "Konstantopouleio", Athens, GRC.
  2. 2Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, GRC.
  3. 3Department of Thoracic Surgery, "Sismanoglio - Amalia Fleming" General Hospital of Attica, Athens, GRC.
  4. 4Department of Air Ambulance Services, Hellenic National Center of Emergency Care (EKAB), Athens, GRC.
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Abstract

Sigmoid volvulus (SV) is a form of mechanical bowel obstruction with a likely multifactorial etiology. It occurs far more frequently in the so-called "volvulus belt" countries than in Western nations. In Western countries, its relatively low incidence has led to a lack of management experience. Establishing a diagnosis can be difficult and challenging, while the timing of presentation is a crucial determinant of prognosis. Delayed admission may result in bowel ischemia and gangrene. These complications are associated with increased morbidity and high mortality. Many aspects of SV management remain debatable, and proposed treatment algorithms are not universally accepted. In most cases of acute, uncomplicated SV, endoscopic decompression is the first-line treatment. However, this approach is commonly associated with SV recurrence if it is not followed by surgery. For complicated SV cases, emergent resection surgery can provide an effective and definitive treatment. Elderly patients and those with severe comorbidities may require careful preoperative assessment and optimization. Definitive surgery under general anesthesia is often postponed in this high-risk population. This review aims to examine the diagnostic challenges associated with acute SV and to evaluate the safety and effectiveness of currently available therapies. Further clinical research is needed to clarify the most appropriate treatment strategies for SV.

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Cite

BibTeXRIS
BibTeX
@article{avgoustou2026update,
  title = {{Update on the Management of Acute Sigmoid Volvulus: Endoscopic Decompression and Definitive Surgical Treatment.}},
  author = {Constantinos Avgoustou and Christina Avgoustou and Konstantinos Skevis and Dimitrios Jannusis},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116789},
  url = {https://europepmc.org/article/MED/42921600},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Update on the Management of Acute Sigmoid Volvulus: Endoscopic Decompression and Definitive Surgical Treatment.
AU  - Constantinos Avgoustou
AU  - Christina Avgoustou
AU  - Konstantinos Skevis
AU  - Dimitrios Jannusis
PY  - 2026
DA  - 2026/09/23
JO  - Cureus
DO  - 10.7759/cureus.116789
UR  - https://europepmc.org/article/MED/42921600
AB  - Sigmoid volvulus (SV) is a form of mechanical bowel obstruction with a likely multifactorial etiology. It occurs far more frequently in the so-called "volvulus belt" countries than in Western nations. In Western countries, its relatively low incidence has led to a lack of management experience. Establishing a diagnosis can be difficult and challenging, while the timing of presentation is a crucial determinant of prognosis. Delayed admission may result in bowel ischemia and gangrene. These complications are associated with increased morbidity and high mortality. Many aspects of SV management remain debatable, and proposed treatment algorithms are not universally accepted. In most cases of acute, uncomplicated SV, endoscopic decompression is the first-line treatment. However, this approach is commonly associated with SV recurrence if it is not followed by surgery. For complicated SV cases, emergent resection surgery can provide an effective and definitive treatment. Elderly patients and those with severe comorbidities may require careful preoperative assessment and optimization. Definitive surgery under general anesthesia is often postponed in this high-risk population. This review aims to examine the diagnostic challenges associated with acute SV and to evaluate the safety and effectiveness of currently available therapies. Further clinical research is needed to clarify the most appropriate treatment strategies for SV.
SN  - 2168-8184
ER  -