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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Volvulus epidemiology and demographics

Introduction

Overview

Overview

Acute mechanical small bowel obstruction is a common surgical emergency where volvulus is the cause in 10% of cases. It is estimated that over 300,000 laparotomies are performed per year in the United States for adhesion-related obstructions such as volvulus. Volvulus originating in the colon is the third most common cause of large bowel obstruction.

Epidemiology and Demographics

Epidemiology and Demographics

Incidence

  • The incidence of volvulus is approximately 2 per 100,000 individuals worldwide.[1][2][3][4][5]
  • Sigmoid volvulus has the highest incidence, followed by cecal volvulus.
  • The incidence of cecal volvulus increases per year, whereas the incidence of sigmoid volvulus remains stable.
  • The incidence of volvulus is higher in those that live in nursing homes or are institutionalized. These patients usually take psychotropic drugs that interfere with colonic motility and can increase the incidence of volvulus.
  • The incidence of gastric volvulus is rare.

Prevalence

  • In 2002 – 2010, the prevalence of colonic volvulus is estimated to be 63,749 cases in the United States annually.[4]

Case-fatality rate/Mortality rate

  • The mortality rate of volvulus is 7 per 100 cases.[3]

Age

  • The incidence of volvulus increases with age; the median age at diagnosis is 70 years.[4][6][5]
  • Sigmoid volvulus has been reported in children and adolescents and is usually associated with abnormal colonic peristalsis.
  • Gastric volvulus is rare and the incidence peaks after the fifth decade.
  • The incidence of neonatal and infantile volvulus is unknown since non-rotation or malrotation of the gut may remain asymptomatic throughout life.[7]
    • In the United States, non-rotation is an incidental finding in 2 out of 1000 upper gastrointestinal contrast studies.
    • In the United States, symptomatic malrotation in neonates occurs in 1 in 6000 live births.

Race

  • Volvulus usually affects individuals of the Black race.[8][9]
    • Black individuals are at increased risk for volvulus because they tend to have a longer mesentery and sigmoid colon.

Gender

  • Most studies have found that volvulus affects men and women equally.[10][11][12]
  • Although some studies have found a predominance in men, cecal volvulus has been found to be more prevalent in younger females.

Region

  • The majority of volvulus cases are reported in Russia, India, Iran, Norway and Africa.[3]
  • In the United States, volvulus only accounts for 0.1 of cases with intestinal obstruction.
References

References

  1. ↑ Katoh T, Shigemori T, Fukaya R, Suzuki H (2009). “Cecal volvulus: report of a case and review of Japanese literature”. World J. Gastroenterol. 15 (20): 2547–9. PMC 2686916. PMID 19469008.
  2. ↑ Consorti ET, Liu TH (2005). “Diagnosis and treatment of caecal volvulus”. Postgrad Med J. 81 (962): 772–6. doi:10.1136/pgmj.2005.035311. PMC 1743408. PMID 16344301.
  3. ↑ 3.0 3.1 3.2 Ballantyne GH, Brandner MD, Beart RW, Ilstrup DM (1985). “Volvulus of the colon. Incidence and mortality”. Ann. Surg. 202 (1): 83–92. PMC 1250842. PMID 4015215.
  4. ↑ 4.0 4.1 4.2 Halabi WJ, Jafari MD, Kang CY, Nguyen VQ, Carmichael JC, Mills S, Pigazzi A, Stamos MJ (2014). “Colonic volvulus in the United States: trends, outcomes, and predictors of mortality”. Ann. Surg. 259 (2): 293–301. doi:10.1097/SLA.0b013e31828c88ac. PMID 23511842.
  5. ↑ 5.0 5.1 Wu MH, Chang YC, Wu CH, Kang SC, Kuan JT (2010). “Acute gastric volvulus: a rare but real surgical emergency”. Am J Emerg Med. 28 (1): 118.e5–7. doi:10.1016/j.ajem.2009.04.031. PMID 20006232.
  6. ↑ Krupsky S, Halevy A, Orda R (1987). “Sigmoid volvulus in adolescence”. J. Clin. Gastroenterol. 9 (4): 467–9. PMID 3655280.
  7. ↑ Burns, Cartland (2006). “Principles and Practices of Pediatric Surgery”. Annals of Surgery. 243 (4): 567. doi:10.1097/01.sla.0000208423.52007.38. ISSN 0003-4932.
  8. ↑ Madiba TE, Aldous C, Haffajee MR (2015). “The morphology of the foetal sigmoid colon in the African population: a possible predisposition to sigmoid volvulus”. Colorectal Dis. 17 (12): 1114–20. doi:10.1111/codi.13042. PMID 26112767.
  9. ↑ Michael SA, Rabi S (2015). “Morphology of Sigmoid Colon in South Indian Population: A Cadaveric Study”. J Clin Diagn Res. 9 (8): AC04–7. doi:10.7860/JCDR/2015/13850.6364. PMC 4576524. PMID 26435933.
  10. ↑ Påhlman L, Enblad P, Rudberg C, Krog M (1989). “Volvulus of the colon. A review of 93 cases and current aspects of treatment”. Acta Chir Scand. 155 (1): 53–6. PMID 2929205.
  11. ↑ Baker DM, Wardrop PJ, Burrell H, Hardcastle JD (1994). “The management of acute sigmoid volvulus in Nottingham”. J R Coll Surg Edinb. 39 (5): 304–6. PMID 7861341.
  12. ↑ Isbister WH (1996). “Large bowel volvulus”. Int J Colorectal Dis. 11 (2): 96–8. PMID 8739835.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: ; Hadeel Maksoud M.D.[2]