Colonic volvulus.

Volvulus has multifactoral causes. It occurs worldwide, and is a common cause of large bowel obstruction. Current knowledge suggests that primary prevention is not possible, so better management is needed if the number of deaths are to be reduced. Most cases of sigmoid volvulus can be nonoperatively decompressed. However, operation is required to remove gangrenous bowel and stop recurrence. Treatment needs to be individualized as appropriate for medically compromised patients. Sound clinical judgment still has an important role in the diagnosis and management of this disorder.