Sigmoid Volvulus (X-ray/CT)
Coffee bean sign, whirl sign on CT
All Pathways
Colorectal SurgeryManagement
Sigmoid Volvulus Management Algorithm (ASCRS)
Sigmoid Volvulus Management Algorithm (ASCRS): Sigmoid Volvulus (X-ray/CT) → Peritonitis or Gangrene? → Emergency Laparotomy.
Pathway Overview
8 steps
Algorithm Steps
8 total
01Start 02Decision Peritonitis or Gangrene?
03End Emergency Laparotomy
Hartmann's or primary anastomosis ± diversion
04Action Endoscopic Decompression
Rigid/flexible sigmoidoscopy + rectal tube
05Decision Decompression Successful?
06Action Elective Sigmoid Resection
Same admission or within 2-4 weeks
07End Sigmoid Colectomy
Primary anastomosis if stable, healthy bowel
08Action Failed Decompression
Proceed to surgery
- Path rejoins step 03Shared downstream outcome
Guideline Source
ASCRS Clinical Practice Guidelines: Colonic Volvulus
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Recurrence after decompression is high
- Definitive surgery recommended if fit
- Gangrenous bowel requires emergency surgery
Applicable Regions
USAUUKEU
US: ASCRS guidelines
Africa/Asia: Higher incidence, often younger patients
Version 1Next review: 2028-01-01
Related Colorectal Surgery Pathways
Next steps
Finish the workflow by opening the most relevant calculator, then convert the session into a live account when you are ready.
Related Resources
Frequently Asked Questions
What is the Sigmoid Volvulus Management Algorithm (ASCRS)?
The Sigmoid Volvulus Management Algorithm (ASCRS) is a management clinical algorithm for Colorectal Surgery. It provides a structured decision tree to guide clinical decision-making, based on ASCRS Clinical Practice Guidelines: Colonic Volvulus.
What guideline is the Sigmoid Volvulus Management Algorithm (ASCRS) based on?
This algorithm is based on ASCRS Clinical Practice Guidelines: Colonic Volvulus (DOI: 10.1097/DCR.0000000000001430).
What are the limitations of the Sigmoid Volvulus Management Algorithm (ASCRS)?
Known limitations include: Recurrence after decompression is high; Definitive surgery recommended if fit; Gangrenous bowel requires emergency surgery. Individual patient factors may require deviation from these recommendations.
Get AI-Powered Analysis Alongside This Algorithm
In AttendMe.ai, the Sigmoid Volvulus Management Algorithm (ASCRS) appears automatically when your clinical question matches — alongside evidence from 3M+ peer-reviewed articles.
Try AttendMe Free