Francois Jausset, Presenter: Nothing to Disclose

Clement Proust, Abstract Co-Author: Nothing to Disclose

Julien Mathias MD, Abstract Co-Author: Nothing to Disclose

Valérie Laurent MD, Abstract Co-Author: Nothing to Disclose

Alain Gilbert Blum MD, Abstract Co-Author: Nothing to Disclose

Denis Marie Regent MD, Abstract Co-Author: Nothing to Disclose

The usual concept of sigmoid volvulus has been recently challenged by Dr. E. Delabrousse’s team by opposing the classical “mesenterico-axial form” to the “organo-axial” form which is characterized by a segment of sigmoid revolving around its longitudinal axis. Thus, we wanted to verify the effectiveness of such an “organoaxial” form and compare our radiological, epidemiological and prognostic data with theirs.  

We performed a monocentric retrospective study of 51 patients between 2003 and 2010. Patients were divided into two groups according to the type of volvulus observed: “mesenterico-axial“ forms when two segments of the sigmoid revolve generating a closed-loop obstruction and “organo-axial” forms in the case of only one distal segment of the sigmoid. We then compared the epidemiological data of both groups taking into acccount their ages means, their therapeutic management and their recurrence rates

In our study, the “organo-axial” form appeared more frequently (61%) than classical “mesenterico-axial” form (35%) and involved an older population (72 versus 62 years). The remaining 4% corresponded to ileosigmoïd knots. Endoscopic management was much more common than surgical treatment, with a same endoscopy failure rate for both groups. Recurrence rate of the “mesenterico-axial” sigmoid volvulus was higher than ” organo-axial” form (82% versus 60%).

The sigmoid volvulus by "organo-axial" rotation being misunderstood and ignored for many years, is a reality. The mean age of patients is higher in “organo-axial” volvulus and their recurrence rate is lower.

The recognition of two different forms of volvulus by the radiologist is therefore likely to be involved in the therapeutic decision between endoscopy and surgical management in the future.

Jausset, F, Proust, C, Mathias, J, Laurent, V, Blum, A, Regent, D, The Organoaxial Sigmoid Volvulus: Myth or Reality?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006802.html