The aetiology and management of sigmoid volvulus in the UK: how much colon need be excised?

The case notes of 15 patients undergoing colonic resection for sigmoid volvulus at St Mark's Hospital over 25 years have been reviewed. Eight patients underwent sigmoid colectomy, four left hemicolectomy and three total colectomy. Although 12 of the 15 patients complained of a constipated bowel habit for 'all their lives' prior to operation, all but two had a much improved bowel habit thereafter, regardless of the extent of the resection. If there is evidence of acute or recent sigmoid volvulus at operation, sigmoid colectomy alone is recommended in the first instance.