Split-wall sign (sigmoid volvulus)

Last revised by Andrea Molinari on 18 Oct 2022

The split-wall sign is one of the signs of sigmoid volvulus. This sign is characterized by the separation of the walls of a single loop of the sigmoid colon due to the invagination of mesenteric fat between them. The intervening fat causes the loop to appear bilobed or C-shaped on axial images, thereby giving it the appearance of two bowel loops.

The split-wall sign signifies either

  • a partial twist
  • an early stage in twisting, still incomplete
  • untwisting of a previous complete twist

History and etymology

Jeffrey M Levsky et al. were the first to describe the sign and coin the term in 2010 1.

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Cases and figures

  • Sigmoid volvulus
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