Sigmoid volvulus vs cecal volvulus

Last revised by Daniel J Bell on 7 Aug 2024

The following points may be helpful to distinguish between sigmoid volvulus and cecal volvulus on plain radiographs.

Sigmoid volvulus
  • arises in the pelvis (left lower quadrant)

  • extends towards the right upper quadrant

  • ahaustral in appearance

  • sigmoid volvulus causes obstruction of the distal large bowel; therefore, the ascending, transverse and descending colon may be dilated

  • few gas-fluid levels may be seen 1

Cecal volvulus
  • arises in the right lower quadrant

  • extends towards the epigastrium or left upper quadrant

  • colonic haustral pattern is maintained

  • distal colon is usually collapsed and the small bowel is distended

  • one gas-fluid level may be seen 1

Imaging differential diagnosis

  • Sigmoid volvulus
  • Cecal volvulus
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