VOLVULUS of the colon is primarily an afflication of older people. It is important because the resulting torsion of the mesentery may rapidly result in infarction and perforation of the bowel. At present the incidence of obstruction due to volvulus is estimated at approximately 10%. The number of cases is certain to increase with an aging population.
Sigmoid volvulus is more common than volvulus of the cecum and tends to occur in an older age group. Most patients give a long history of poor bowel habits and chronic constipation with frequent use of cathartics. It is interesting that the incidence of colonic volvulus is about four times greater in the Middle Eastern countries than in the United States. It has been suggested that this may be due to a diet high in vegetables and residue.
Although the mechanisms causing cecal and sigmoid volvulus are similar, the therapeutic approach to each