Difference Between Sigmoid and Cecal Volvulus

Key Difference – Sigmoid vs Cecal Volvulus
 

Volvulus refers to a twist. In medical terms, colonic volvulus refers to the twisting of the colon. This happens due to the obstruction of the colon. Colonic volvulus is mainly divided into sigmoid volvulus and cecal volvulus based on the place of the twist or the obstruction. Sigmoid volvulus is the twisting of the sigmoid colon of the large intestine. Cecal volvulus takes place due to the torsion caused in the cecum area. The key difference between the sigmoid and cecal volvulus is the site of the volvulus or twist in the bowel. The sigmoid volvulus is the twist that takes place in the sigmoid colon, whereas cecal volvulus is the twist that takes place in the cecum area. Both result in bowel obstruction.

CONTENTS

1. Overview and Key Difference
2. What is Sigmoid Volvulus
3. What is Cecal Volvulus
4. Similarities Between Sigmoid and Cecal Volvulus
5. Side by Side Comparison – Sigmoid vs Cecal Volvulus in Tabular Form
6. Summary

What is Sigmoid Volvulus?

Sigmoid volvulus is one of the main factors for Bowel obstruction. It can be defined as the twist that takes place in the sigmoid colon on its mesentery. Sigmoid volvulus is the main form of volvulus found among the people living in the United States of America and in Western Europe. The sigmoid colon is the point where it forms a junction with the descending colon and the rectum. Therefore, it becomes a prime location for a twist to take place, resulting in sigmoid volvulus. The elongated mesentery of the sigmoid colon can also be a factor for sigmoid volvulus. The loop must be of considerable, and the mesocolon must be long and narrow for the formation.

The clinical symptoms of sigmoid volvulus are large bowel obstructions, constipation, bloating of the abdomen, vomiting and nausea. The onset of the symptoms can be either acute or chronic. The causes of sigmoid volvulus are geographically specific reasons, chronic constipation and excess fibre-rich diets. The sigmoid volvulus is also associated with chronic neurological conditions and chronic psychiatric conditions.

The diagnosis of this condition takes place via abdominal radiographs. These radiographs show dilated loops of the colon. The treatment of the condition includes endoscopic detorsion. Detorsion can be performed via barium enema (a type of an X-ray imaging), rigid proctoscopy, flexible sigmoidoscopy, or colonoscopy.

What is Cecal Volvulus?

Cecal volvulus takes place when torsion is created in the cecum around the mesentery. This results in bowel obstruction, and if unrecognized it can result in bowel perforation and faecal peritonitis. Cecal volvulus accounts for nearly 10 % of all the intestinal volvulus. Cecal volvulus is common among young patients than in elder patients, whereas it is the vice versa in sigmoid volvulus. In cecal volvulus, the cecum twists and inverts. The twist occupies the left upper quadrant of the abdomen. The terminal end of the ileum is also twisted along with the cecum in most occurrences.

Cecal volvulus has another variant of the condition known as cecal bascule. This occurs when the cecum undergoes folding without any torsion being created. Cecal bascule is prevalent among 10 % of the population that show symptoms of volvulus.

The symptoms of cecal volvulus include abdominal pain, vomiting and abdominal distension. The treatment is detorsion of the bowel, although there are many chances in which the foldings can reoccur following the treatment.

What are the Similarities Between Sigmoid and Cecal Volvulus?

• Both types result in bowel obstruction.
• Both volvuli occur as a result of twisting of specific parts of the abdomen.
• Both volvuli result in abdominal pain, vomiting.
• The treatment for both conditions is detorsion of the bowel.
• Both types can cause acute intestinal obstruction.
• Both types can be diagnosed via radiographic observations.

What is the Difference Between Sigmoid and Cecal Volvulus?

Summary – Sigmoid vs Cecal Volvulus 

Volvulus is one of the most common reasons for bowel destruction. There are two main types of volvuli namely sigmoid volvulus and cecal volvulus. The sigmoid volvulus refers to the twist that takes place in the sigmoid colon, and it is able to spread to the upper area of the bowel. The cecal volvulus refers to the torsion that is created due to a twist in the cecum area. This can spread in any direction to cause bowel obstruction. This condition is characterized by severe abdominal pain, vomiting and nausea. This is the difference between sigmoid volvulus and cecal volvulus.

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Reference:

1.Gaillard, Frank. “Caecal volvulus | Radiology Reference Article.” Radiopaedia.org. Available here 
2.Jones, Jeremy. “Sigmoid volvulus | Radiology Reference Article.” Radiopaedia.org. Available here  
3.Gingold, Daniel, and Zuri Murrell. “Management of Colonic Volvulus.” Clinics in Colon and Rectal Surgery, Thieme Medical Publishers, Dec. 2012. Available here  

Image Courtesy:

1.’Sigmoidvolvulus’By Mont4nha – Own work, (Public Domain) via Commons Wikimedia  
2.’Stomach colon rectum diagram-en’By  William Crochot – US PD picture., (Public Domain) via Commons Wikimedia