Multiplex attacks in sigmoid volvulus

Keywords: Sigmoid volvulus, Multiple attacks, Multiplex attacks


Objectives: Sigmoid volvulus (SV) recurs in about one quarter of the patients, whereas multiplex (≥3) attacks are quite rare and attacks with five or more times are extremely rare. The aim of this study was to evaluate multiplex SV attacks in our series and worldwide data.

Methods: In Ataturk University Faculty of Medicine Department of General Surgery, among 1,071-case SV series, data were evaluated retrospectively in 612 patients, while prospectively in 459 with respect to age, gender, previous volvulus attacks, and prognosis. Worldwide data were obtained from Web of Science database and they were compared with our results.

Results: Mean SV attack count, multiple- (≥2) and multiplex- (≥3) attack rates were 1.4, 26.1%, and 4.2%, respectively, in our series, while they were 1.7, 26.7%, and 3.2%, respectively, in worldwide data (p>0.05, in all). In our series, recurrence rates were 26.1%, 19.3%, and 51.2%, respectively, (p<0.001, in all), while mortality rates were 7.3%, 13.7%, and 19.5%, respectively, (p<0.001, in all) in single-, double-, and multiplex- (≥3) attack patients.

Conclusion: Although multiplex (≥3) attacks are uncommon in SV, when it goes up, elective surgery must be considered in selected cases to avoid repetitive attacks and related high mortality.


How to cite this: Disci E, Peksoz R, Agirman E, Atamanalp SS. Multiplex attacks in sigmoid volvulus. Pak J Med Sci. 2024;40(6):1185-1189.  doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to Cite
Disci, E., Peksoz, R., Agirman, E., & Atamananalp, S. S. (2024). Multiplex attacks in sigmoid volvulus. Pakistan Journal of Medical Sciences, 40(6).
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