Volvulus of the sigmoid colon is associated with hypotrophy of the left lateral segment of the liver and the absence of sigmoid diverticulum

Abstract

Purpose: To investigate the possible relationships between sigmoid diverticula, the volume of the left lateral segment of the liver and sigmoid colon volvulus.

Material and methods: The presence of sigmoid diverticula was analyzed in 36 patients (24 men, 12 women; mean age, 70.77±19.86 [SD] years) with sigmoid volvulus (group 1). The volumes of left lateral segment of the liver (i.e., segments 2 and 3 and further referred to as liver 1), liver 2 (i.e., segments 1, 4, 5, 6, 7 and 8), total liver volume and liver volume ratio (LVR) (i.e., [liver 1/liver 2]×100) were calculated from abdominal CT performed distantly from the acute episode of sigmoid volvulus. Results of volumetric measurements in group 1 were compared with those of two groups of age and gender-matched control patients without hepatopathy: one patient group with sigmoid diverticula (group 2) and one group without sigmoid diverticula (group 3).

Results: No patients with sigmoid volvulus had diverticulum. Liver 1 volume was lower in group 1 (193.8cm³) than in group 2 (273.75cm³) (P=0.0003). Mean LVR was greater in group 2 (24.18%) than in group 1 (14.46%) (P=1×10^-7) and group 3 (18.36%) (P=0.003). Mean LVR was greater in group 3 than in group 1 (P=0.01). No significant differences in liver 2 volume and total liver volumes were found between the 3 groups.

Conclusion: Elasticity of colon wall associated with relative hypotrophy of left lateral segment of the liver are significantly associated with sigmoid volvulus. Further studies are needed to elucidate the pathophysiological mechanisms behind this association.

Keywords: Left lateral segment of the liver hypotrophy; Liver volume; Sigmoid diverticula; Sigmoid volvulus.