Volvulus of the sigmoid colon.

Volvulus of the sigmoid colon is an important condition, with multifactorial causes, that occurs worldwide, but with a marked variation in geographic incidence. Accurate diagnosis is essential for optimal management. Most patients can be managed by nonoperative decompression followed by elective resection of the sigmoid colon. When emergency laparotomy is necessary, resection is generally the best procedure. However, individualization of treatment is appropriate in medically compromised patients or in special circumstances. Current knowledge suggests that primary prevention is not possible, so better management is essential if the number of deaths associated with volvulus of the sigmoid colon are to be reduced. Sound clinical judgment still has an important role in the diagnosis and management of this disorder.