Sigmoid volvulus rotation occurs:

(Anti-clock wise) (1197-Baily & Love 24th) (1192-B &L 25th)SIGMOID VOLVULUS - Most common cause of large bowel obstruction in indigenous black Africans.* Rotation nearly always occurs in an anticlockwise direction* Predisposing causes - Band of adhesions (Peridiverticulitis) overloaded pelvic colon, Long pelvic mesocolon, narrow attachment of pelvic mesocolon.* Plain X-ray film of abdomen - The distended loop may assume a 'coffee bean' shape.* In caecal volvulus the concavity of the "coffee bean' points towards the right lower abdominal quadrants and in sigmoid volvulus it points towards the left lower quadrants.* On barium enema, "bird's beak" or "ace of spades" deformity with spiral narrowing of the upper end of the lower sigments is pathognomic (739-CSDT 11th)