Sigmoid volvulus is the abnormal twisting of the sigmoid colon along its mesentery. It accounts for 2-5% of intestinal obstruction cases including small bowel and large bowel. Sigmoid volvulus is more common than cecal volvulus, with an incidence rate of 65 to 80 % of all colonic volvulus. In Western countries, elderly males (>70 years) are usually affected. It is a potentially devastating and life-threatening condition. Therefore, immediate correct diagnosis is essential for the prompt treatment and avoid further complications such as bowel ischemia or perforation.

Mesentero-axial and organo-axial subtypes of sigmoid volvulus are defined in the literature. Although many of the classical radiological signs of the mesentero-axial subtype such as whirl sign, X marks the spot sign, has been reported, limited case reports and series are published on organo-axial subtype. There is sparse literature correlating the two subtypes of volvulus with radiological signs, clinical management, and outcomes.