Sigmoid volvulus versus cecal volvulus

Last revised by Dr Marianne Cossens on 10 Apr 2021

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

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 air-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 air-fluid level may be seen 1

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