Twisted colon (colonic volvulus): A twisted colon is a twisting of a portion of the colon around its mesentery creating a colonic obstruction. The sigmoid colon and cecum are the most common portions of the colon involved in a colonic volvulus.

A twisted colon can be very painful. A lack of fiber in your diet is one of the main contributing factors to how your colon got twisted; however, there many other possibilities: chronic constipation, the presence of pathogenic organisms, nutritional deficiencies, a toxic-laden colon, and stress. When twists are present they often occur along with constrictions, ballooning and prolapses that are not normal in the colon.

There are two types of twisted colons: Sigmoid volvulus and cecal volvulus

Sigmoid Volvulus

Background: Sigmoid volvulus is the most common form of volvulus of the gastrointestinal tract and is responsible for 8% of all intestinal obstructions. Sigmoid volvulus is particularly common in elderly persons. Patients present with abdominal pain, distension, and absolute constipation. Predisposing factors include chronic constipation, mega colon, and an excessively mobile colon. Plain abdominal radiograph findings are usually diagnostic. Decompression may be achieved with the introduction of a stiff tube per the rectum, aided by endoscopy or fluoroscopy. Early radiographic recognition is important to prevent mortality related to sigmoid volvulus.

Cecal Volvulus

Background: The term cecal volvulus is a misnomer because, in most patients with cecal volvulus, the torsion is located in the ascending colon above the ileocecal valve. In general, a partial malrotation is necessary for cecal volvulus to occur, because the cecum and also parts of the ascending colon are involved. Early diagnosis is essential to reduce the high mortality rate reported with this condition, which is essentially a closed-loop obstruction that may lead to vascular compromise with consequent gangrene and perforation.